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Biomedical subjects

B J Abrams

Publications and source records attributed to B J Abrams.

6 recordsLinked to original sources
PubMed1999

Ultrasound for the detection of intraperitoneal fluid: the role of Trendelenburg positioning.

A prospective, observational study was performed to evaluate the role of Trendelenburg positioning in improving the sensitivity of the single-view ultrasound examination. Hemodynamically stable patients undergoing diagnostic peritoneal lavage (DPL) were assigned to one of two groups: supine or 5 degrees of Trendelenburg positioning. Baseline right intercostal oblique images of Morison's pouch were obtained followed by additional images for each 100 cc of lavage fluid instilled into the peritoneal cavity. The initial volume of fluid required to identify an anechoic stripe was recorded for each patient. Patients were excluded if they had (1) a positive DPL for hemoperitoneum (defined as 10 cc of gross blood or >100,000 red blood cells/microL), (2) positive baseline ultrasound study, (3) hemodynamic instability, or (4) lack of documentation (ie, baseline/subsequent hard copy images were not obtained or inadequately demonstrated anechoic stripe). The mean quantity of fluid for visualization of the anechoic stripe was 443.8 cc in the Trendelenburg group (n = 8) and 668.2 cc in the supine group (n = 11). These means were statistically different (P < .05, t test). The median amount of fluid needed for visualization of the anechoic stripe was 400 cc and 700 cc for the Trendelenburg and supine groups, respectively.

Abdominal Injuries↗
PubMed1999

Comparison of staples versus sutures in the repair of penetrating cardiac wounds.

BACKGROUND: Several literature reports advocate the use of skin staplers for repair of penetrating cardiac wounds during emergency thoracotomy. Our study goal was to objectively determine if stapling is a more efficient method of closure compared with suturing without compromising the strength of the repair. METHODS: This randomized, nonblinded study was conducted in a swine model. A total of four incisions, two per ventricle, were made in each animal. The 2-cm full-thickness incisions were repaired with either sutures or staples, and the time required to close each wound was recorded. After wound repair, the animals were killed. The four wounds were isolated by removing 4.0-cm strips of myocardium oriented perpendicular to the incision. Each strip was then placed on a tensile force testing machine, and the breaking strength of the sutures and staples was measured. RESULTS: The tensile force test showed that stapled and sutured wounds have equivalent mechanical strength. The mean time of closure for stapled wounds was substantially less than that for sutured wounds. CONCLUSION: In this swine model, stapling took significantly less time and had equal mechanical strength compared with suturing for repair of penetrating cardiac wounds. Stapling during emergent resuscitation may be preferable to suturing.

Animals↗
PubMed1996

Radiographic imaging modalities for the patient in the emergency department with abdominal complaints.

The emergency physician should be aware of the sensitivity and specificity of any radiologic study being considered. Radiographic examinations should be used to answer specific questions raised by the history and physical examination. The need to obtain a given radiologic evaluation should be based on the potential information it may reveal and the likelihood that this information will alter patient care. This cost-effective approach minimizes unnecessary radiation exposure and has been advocated by many authorities. The emergency physician should resist the "knee jerk" tendency to order radiographs to reassure himself or herself of the safety of the patient at discharge. Documentational and legal concerns are equally invalid reasons, as is the feeling that "it's what we always order for patients with this abdominal complaint." A given study may be indicated if the yield is acceptable and treatment of the patient may be altered by the results.

Abdominal Pain↗
PubMed1993

Exuberant keloidal formation.

Keloids are disfiguring deformities that occur after trauma or wounding of the skin, most commonly among blacks. The case presented here is unusual because of the number of keloids and the massive size of one. The patient underwent full surgical excision together with intraoperative and postoperative steroid injections with good cosmetic results. Various causes of keloids are reviewed as are the histopathologic differences between hypertrophic scars and keloids. Alternative surgical and nonsurgical treatment techniques are examined.

Adult↗
PubMed1988

The values and value stability of emotionally handicapped and normal adolescents.

This study addresses two basic questions: (1) Do the value rankings of conduct-disorder, anxiety-withdrawal, and normal adolescents differ? (2) Are the value rankings of the two groups of emotionally handicapped adolescents less stable than the value rankings of the normal group? Value stability was viewed in relation to the broader concepts of identity and psychopathology. While a number of studies have examined value differences among different groups of adolescents, few studies have examined the value stability of adolescents. A total of 148 15- to 18-year-old adolescents were administered the Rokeach Value Survey on two separate occasions (3-week interval) to measure value differences and value stability. The two groups of emotionally handicapped adolescents were classified using the Revised Behavior Problem Checklist. Results revealed that all three groups shared similar values; very few value differences across groups were found on both testings. All three groups shared moderate to low levels of value stability. The findings suggest that both types of emotionally handicapped adolescents are similar to normal adolescents in their stated values and the stability of those values. Results are discussed in terms of possible explanations of the findings, and implications for those who work with adolescents and for future research on adolescent values.

Adolescent↗