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Biomedical subjects

C R Smith

Publications and source records attributed to C R Smith.

At least 307 records · Page 17Linked to original sources
PubMed1983

Pseudoocclusion of femoropopliteal bypass grafts.

Pseudoocclusion has occurred when a patent graft is mistaken for a thrombosed graft, often because of reduced inflow. We reviewed 13 patients with pseudoocclusion of 14 grafts to analyze the surprising patency of certain grafts in spite of low flow. Two iliopopliteal and 12 femoropopliteal saphenous vein grafts developed pseudoocclusion 6 months to 6 years (mean 2.6 years) after the original procedure. Ten limbs presented with claudication, two with rest pain, and two with nonviable tissue. Femoral pulses were decreased in 13 limbs and distal pulses were absent in all limbs. Graft thrombosis was suspected in all cases. Occlusion proximal to the graft, either iliac (n = 11) or femoral (n = 2), was found in all 13 limbs studied angiographically. Ten limbs had one- or two-vessel runoff, and only three limbs had three-vessel runoff. Pseudoocclusions were corrected with a variety of inflow procedures, with return of pulses and resolution of symptoms in 13 limbs. One failure resulted in major amputation. We concluded that certain grafts will remain patent in spite of greatly reduced inflow and that recurrence of symptoms does not always signify graft thrombosis. Patency in spite of low flow could not be related to runoff, and autogenous vein appeared to be the graft material most tolerant of low flow.

Aged↗
PubMed1982

Sleeping patterns in upper-middle-class families when the child awakens ill or frightened.

Prior research on whether parents and children ever share a bed is scanty. Some experts have written that if parents take their frightened child into bed with them, there will be "devil to pay." Using a questionnaire, we surveyed 415 upper-middle-class parents of 576 children. We asked if, when their child awoke ill or frightened, they took the child into their bed. They commonly did. We question whether explanations that ascribe the cause of psychopathologic disorders to specific events may not be too simplistic. To date, too much attention may have been paid to the events, such as parents and children sharing a bed, are not enough has been devoted to the context, motivation, and setting in which these events occur.

Adult↗
PubMed1982

Knowledge of and compliance with drug regimens in the elderly.

In an interview study of 545 patients recently discharged from The Johns Hopkins Hospital, data were collected on the patients' knowledge of their diseases, knowledge of drug purpose, and compliance with the prescribed drug regimen. The interrelationships of these variables were compared in patients under age 65 and patients aged 65 or older. Age-related factors and trends were sufficiently important to warrant further investigation. Knowledge of and compliance with drug regimens may reflect doctor-patient relationships. Understanding the patterns of drug use offers a potential for appropriate strategies in clinical practice.

Age Factors↗
PubMed1982

Differences between read and spontaneous speech of deaf children.

Recordings were made of 20 congenitally deaf children, who produced spontaneous speech and, at a later session, read their own spontaneous utterances. Intelligibility scores and judgments of appropriateness of intonation, stress, timing, and sentence contour were obtained from experienced listeners. Read-spontaneous speech was more intelligible than spontaneous speech for 16 of the 20 children. Percentage of correct phoneme articulation was not significantly related to intelligibility.

Child↗
PubMed1982

Health education program effects on the management of hypertension in the elderly.

Because the elderly are viewed as having more difficulty in complying with therapy, this analysis was directed at the effects of a health education program on their control of primary hypertension when compared with a younger population. The program consisted of three sequential interventions introduced in a randomized factorial design. Depsite the fact that elderly patients had more chronic disease, more complications from hypertension, and were receiving more complex drug therapies than younger patients exposed to the same experimental interventions, they demonstrated significantly higher levels of compliance with drug therapy, significantly higher levels of appointment keeping, and no difference in the proportion having their BP under control at two-year-follow-up. Longitudinal data collected at five-year follow-up indicate no decay effect. These results indicate such programs can be successfully implemented and equally effective for an elderly population.

Aged↗
PubMed1981

Vascularity of gastrointestinal staple lines demonstrated with silicone rubber injection.

Gastrointestinal stapling devices were applied across canine small intestine, and then the blood supply of the stapled segments was immediately filled with silicone rubber. After tissue clearing and microdissection, the outstanding vascularity of the staple lines was clearly demonstrated. The B configuration of the closed staple allows blood vessels of substantial size to pass through it. This might make staple technique especially advantageous whenever vascularity is critical.

Animals↗
PubMed1981

Placental involvement in congenital neuroblastoma.

We describe two cases of congenital neuroblastoma involving the placenta and review previously reported cases. The placentae in congenital neuroblastoma have a bulky, hydropic appearance, and contain tumour cells which are confined to the fetal circulation. The tumour emboli are not macroscopically identifiable. Pathophysiological mechanisms of placental involvement by fetal and maternal malignancies are considered. The rarity of this lesion may be artefactual, and may result from failure to examine grossly enlarged placentae in cases of stillbirth and hydrops fetalis. Congenital malignancy must be considered in the differential diagnosis of an abnormally large placenta.

Adrenal Gland Neoplasms↗
PubMed1981

Considerations regarding clinical safety and tolerability of antibiotics in serious and nosocomial infections.

Patients with severe gram-negative infections are often treated with aminoglycosides, cephalosporins, or a combination of these. Aminoglycosides cause nephrotoxicity and ototoxicity. Duration of treatment and dose are directly related to the incidence of toxicity. Nephrotoxicity occurs in 10% to 20% of patients, is mild to moderate in severity, and is often reversible. Tobramycin causes nephrotoxicity less frequently than does gentamicin. Ototoxicity may be associated with auditory or vestibular changes. Auditory toxicity occurs at high frequencies in 10% of patients and is rarely clinically apparent, but it may not be reversible. Cephalosporins cause different adverse effects, which can be classified as those due to: (1) the physical-chemical properties of the cephalosporin--pain on injection and thrombophlebitis; (2) drug hypersensitivity--rash, exfoliative dermatitis, hemolytic anemia, eosinophilia, thrombocytopenia, fever, interstitial nephritis, and anaphylaxis, (3) dose--positive Coombs reaction, glomerulotubular dysfunction, central nervous system dysfunction, platelet dysfunction, leukopenia, and agranulocytosis; and (4) other causes--diarrhea, pseudomembranous colitis, prolonged prothrombin time, disulfiram-like effect, colonization, and super-infection. Use of cephalothin with gentamicin or tobramycin increases the incidence of nephrotoxicity. In patients with severe infections, election of an aminoglycoside or cephalosporin may depend on the relative toxicity of the drugs. Well-designed comparative studies are needed to determine the relative frequency and clinical significance of these adverse effects.

Aminoglycosides↗
PubMed1981

Description of a disposable individual-mouse urine collection apparatus.

An inexpensive, individual mouse urine collection apparatus was constructed from a 250 ml conical polypropylene centrifuge tube and wire cloth. The construction did not require special tools, and was completed in 1 hour. This apparatus allowed the ad libitum feeding and watering of individual mice during the urine collection period. Volumes of urine collected ranged from 0.5-2.0 ml per 24 hours per 25 g mouse.

Animals↗