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Biomedical subjects

B Romanowski

Publications and source records attributed to B Romanowski.

At least 55 records · Page 3Linked to original sources

Meningitis complicating transsphenoidal hypophysectomy.

The case records of 98 patients who underwent a transsphenoidal hypophysectomy between 1969 and 1979 were examined to establish the frequency of postoperative cerebrospinal rhinorrhea and meningitis. There were seven cases of rhinorrhea and six of meningitis following the procedure. Five of the six patients with meningitis had diabetes mellitus and three of the seven with rhinorrhea had meningitis; thus, both diabetes and rhinorrhea were established as significant risk factors (P less than 0.001) in the development of meningitis after this operation. There were two proven cases of meningitis due to anaerobic organisms and a further two suspected cases. The prophylactic use of antibiotics did not prevent the development of meningitis in this series of patients.

Adult↗

Normalization effect of preceding protein meals on "diabetic" oral glucose tolerance in Eskimos.

Routine testing of 76 clinically non-diabetic Eskimos showed marked impairment of oral glucose tolerance in 54% but normal intravenous glucose tolerance in most of these.Total insulin output following the glucose drink was not found different in Eskimos with normal and abnormal glucose tolerance nor did lean meat meals given 60 minutes before the glucose significantly increase it.Intolerance to oral glucose loads appeared significantly related to a delay of insulin release and both timing of insulin response and shape of blood glucose curve normalized in the meat-preceded tests.

Adult↗

Contrast-enhanced, ultrafast 3D pulmonary MR angiography in a single breath-hold: initial assessment of imaging performance.

An ultrafast three-dimensional (3D) sequence was developed, enabling the acquisition of 44 contiguous 2.0- to 2.2-mm thin sections, during intravenous application of paramagnetic contrast, in a single breath-hold. To estimate the potential clinical usefulness, images were assessed qualitatively and quantitatively with regard to visibility of main, lobar, segmental, and subsegmental pulmonary arteries. Five volunteers were examined using a 192 x 192 matrix with an imaging time of 23 seconds and five other volunteers with a 160 x 160 matrix (18 seconds). Each volunteer was imaged in apnea and during shallow respiration. The breath-held 23-second scans revealed excellent image quality and near complete visualization of central and segmental, as well as 81% of subsegmental, pulmonary arteries. Imaging time can be shortened to 18 seconds with only marginal loss in visualization performance (P < .05). Respiratory motion was found to cause significant worsening of image quality and vessel detectability. To maintain relevance in a clinical setting, imaging time can be minimized at the cost of a reduction in spatial resolution.

Adult↗

Target definition and trajectory optimization for interactive MR-guided biopsies of brain tumors in an open configuration MRI system.

We present an imaging strategy for planning and guiding brain biopsies in an open configuration MR system. Preprocedure imaging was performed in a 1.5-T MR system and was designed to provide, in a clinically efficient manner, high resolution anatomical and functional/physiologic information for precise definition and tissue characterization of the target, aiming at optimization of the biopsy trajectory for planning a safe and accurate procedure. The interventions were performed in a .5-T open bore magnet, and imaging was optimized to provide the imaging quality and temporal resolution necessary for performing the procedure interactively in near real time. Brain biopsies of 21 patients were performed in a 10-month period. Segmentation and surface rendering analysis of the lesions and vascular structures and dynamic MR perfusion and cortical activation studies provided an efficient and comprehensive way to appreciate the relationship of the target to surrounding vital structures, improved tissue characterization and definition of the tumor margins, and demonstrated the location of essential cortex, allowing appropriate placement of the burr hole and choice of optimal trajectory. Interactive protocols provided good visualization of the target and the interventional devices and offered the operator real-time feedback and control of the procedure. No complications were encountered. Advanced methods of image acquisition and processing for accurate planning of interventional brain procedures and interactive imaging with MR guidance render feasible the performance of safe and accurate neurointerventional procedures.

Adult↗

Improved diagnosis of gonorrhea in women.

Single endocervical cultures are estimated to be 85-95% reliable in the diagnosis of gonorrhea; a properly obtained rectal culture increases this yield by 5%. In this prospective trial, the increased diagnostic yields from two first-day endocervical cultures and second-day endocervical and rectal cultures were examined. The value of cervical gram smears was also reviewed. During a six-month period, 748 women were evaluated on day 1, with 195 returning for second-day cultures. The mean increased diagnostic yields were 2.2% for the second first-day endocervical culture, 2.9% for second-day cultures, and 4.0% for rectal cultures.

Adolescent↗

Detection of Treponema pallidum by a fluorescent monoclonal antibody test.

Definitive diagnosis of early syphilis currently requires dark-field microscopy and/or a newly reactive serologic test for syphilis. The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologic diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of serologic reactivity. We used a pathogen-specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. Thus the fluorescent monoclonal antibody test for detection of T. pallidum in direct smears is as sensitive and specific as dark-field microscopy for the diagnosis of infectious syphilis. It has the potential to provide a convenient, accurate means for definitive diagnosis of genital ulcer disease by health care personnel without ready access to dark-field microscopy.

Adult↗

Enoxacin in the therapy of anal and pharyngeal gonococcal infections.

In this randomized double-blind study, 51 patients with uncomplicated anal or pharyngeal Neisseria gonorrhoeae infection were evaluated to determine the efficacy and safety of 200- or 400-mg of enoxacin twice a day for two days. Enoxacin cured all anal infections and 12 out of 13 pharyngeal infections. All 82 isolates of N. gonorrhoeae tested were inhibited by 1 microgram of enoxacin/ml.

Administration, Oral↗

Epidemiology of an outbreak of infectious syphilis in Alberta.

An outbreak of 1089 cases of infectious syphilis (primary, secondary and early latent) which occurred in the province of Alberta from 1981 to 1987 was analysed by stage of disease, age, sex, sexual preference and geographic distribution. The majority of cases occurred between 1983 and 1985 inclusive. Men accounted for 75.8% of the study population. The majority of men (71%) and women (98.5%) were heterosexual. Of the infected women, 58.7% were North American Indians and many worked as prostitutes. There was clustering in urban locations with 71.8% and 17.7% of cases reported in Edmonton and Calgary, respectively. Clinical signs of syphilis were more commonly present in men than women. Contact tracing played an important role in controlling the outbreak with 15.9% of men and 44.7% of women being diagnosed and treated as a result of this activity.

Adolescent↗

Relationships of cervical cytologies to selected variables among women attending a sexually transmitted disease clinic.

A retrospective chart review was conducted for one year to determine cervical cytological abnormalities and their distribution among women attending a STD clinic, and to analyse cervical cytologies by STD diagnosis and history or presence of genital warts. Analysis was performed on 790 Pap smears. Most (60%) cytologies were benign. Prevalence of STD among CIN-1 cytologies (78%) was significantly higher (P = 0.02) than among benign cytologies (46%). Commonest cytologies presenting among youngest age groups were CIN-1/condyloma, CIN-1, CIN-2. Women with preceding or concurrent clinical HPV infection had significantly more HPV associated changes on cytology (P < 0.001) than women with no such history. The presentation of cytological abnormalities considered to be precursors to cervical cancer among sexually active young women demonstrates the importance of Pap smear testing of STD clinic populations.

Adult↗