Search PubMed⌕ Search

Biomedical subjects

C S Cox

Publications and source records attributed to C S Cox.

At least 55 records · Page 3Linked to original sources
PubMed1992

Immediate positive pressure ventilation with positive end-expiratory pressure (PEEP) improves survival in ovine smoke inhalation injury.

BACKGROUND: The purpose of this study was to compare the effects of immediate initiation of positive pressure ventilation (PPV) with positive end-expiratory pressure (PEEP) versus the initiation of PPV with PEEP only after hypoxemia ensued following severe smoke inhalation injury. METHODS: We prospectively evaluated chronically instrumented adult sheep treated with immediate versus delayed PPV with PEEP and compared oxygen requirements, hemodynamics, pleural fluid formation, postinjury survival, and tracheobronchial pathologic processes among groups. The immediate group (group I; smoke, n = 6; sham, n = 2) underwent tracheostomy and bilateral chest tube placement before they received inhalation injury. They were then immediately placed on PPV with PEEP (12 cm H2O). The animals in the delayed group (group D) (n = 6) were placed on PPV with PEEP when arterial hypoxemia (PaO2 < 80 mm Hg [11.2 kPa] on 0.4 FIO2) or respiratory distress developed. RESULTS: Groups were matched for smoke exposure and peak carboxyhemoglobin. Both groups developed a characteristic decrease in PaO2/FIO2 ratio. Initiation of PPV + PEEP improved PaO2 in the delayed group (69 +/- 7 to 126 +/- 21 mm Hg [9.2 +/- 0.9 to 16.7 +/- 2.8 kPa]). Pleural fluid output was greater in the immediate group compared with the delayed group (1559 +/- 415 vs. 426 +/- 236 mL). At 96 hours after injury five of six animals in the delayed group had died. In contrast, six of six animals in the immediate smoke group survived 96 hours (p < 0.05 versus delayed group). The immediate group had fewer and less extensive tracheobronchial casts at necropsy. CONCLUSIONS: Immediate PPV + PEEP did not prevent the development of hypoxia and was associated with increased pleural fluid formation. Death within 96 hours in the delayed group was the result of respiratory failure aggravated by bronchial cast formation despite vigorous pulmonary toilet. Early positive pressure ventilation with PEEP, preferably initiated immediately after the inhalation insult, significantly increases short-term survival and is associated with decreased tracheobronchial cast formation in this ovine model of severe smoke inhalation injury.

Animals↗
PubMed1992

Clinical manifestations of pulmonary fungal infections.

Coccidioidomycosis, histoplasmosis, cryptococcosis, and blastomycosis are the most common deep pulmonary fungal infections encountered by the clinician. Each has a particular environmental habitat. As world travel increases, exposure to these infections becomes increasingly more common. The article reviews the microbiology, natural history, and clinical and laboratory findings of these diseases. Treatment options for these infections also are discussed.

Blastomycosis↗
PubMed1992

Plan and operation of the NHANES I Epidemiologic Followup Study, 1987.

This report describes the plan and operation for the 1987 data collection wave of the Epidemiologic Followup to the first National Health and Nutrition Examination Survey (NHANES I). Tracing and data collection were conducted on 11,750 persons 25-74 years of age at NHANES I who were not known to be deceased in the 1982-84 and 1986 data collection waves of the NHANES I Epidemiologic Followup Study.

Adult↗
PubMed1992

Neonatal transport in Texas.

The critically ill newborn requires specialized care, which is generally provided in neonatal intensive care units (NICUs). We surveyed all identifiable NICUs in the state of Texas to study deficiencies in the current system. Despite the existence of many neonatal transport teams, little or nothing has been done to coordinate similar efforts at different programs or to organize programs into sharing the responsibility of transport among the less served areas of Texas. The lack of adequate reimbursement may be a limiting factor in the organization and regionalization of neonatal transport. We urge further efforts toward coordination and regionalization of transport with an examination of reimbursement policies to allow teams to share equally the responsibility of neonatal transport in Texas.

Catchment Area, Health↗
PubMed1991

Staging and surgery for lung cancer.

Surgery for lung cancer has evolved dramatically over the years. Although 5-year survival for patients with lung cancer remains low, new surgical techniques have increased survival rates for different stages of lung cancer. The article reviews the stages of lung cancer, the different surgical techniques used to treat lung cancer, and the complications of those surgical techniques.

Carcinoma, Non-Small-Cell Lung↗
PubMed1991

Development and current status of a new intracorporeal membrane oxygenator (IVOX).

The IVOX (intravascular oxygenator) is an intracorporeal, hollow-fibre membrane oxygenator and carbon dioxide (CO 2) removal device. The IVOX is surgically placed into the vena cava via a femoral or jugular venotomy. Oxygen (O 2) is pulled through the hollow fibres by a vacuum pump controlled by a flow meter. There is no extracorporeal circulation of blood. Gas exchange occurs as the patient's blood flows over several hundred hollow fibres. Inlet and outlet gas conduits exit a small skin incision for inflow of 0 2 and outflow of CO 2. Studies in sheep show that the IVOX can support approximately 30% of gas exchange requirements. The position of the IVOX in the vena cava does not affect haemodynamics or cause thromboembolic complications. It can remain in place for up to 22 days without affecting haematologic or blood chemistry parameters. The IVOX is currently undergoing clinical trials at selected medical centres in patients with acute respiratory failure.

Animals↗
PubMed1991

A new intravascular membrane oxygenator to augment blood gas transfer in patients with acute respiratory failure.

The IVOX (intravascular oxygenator) is an intracorporeal, hollow-fibre membrane oxygenator and carbon dioxide (CO2) removal device. The IVOX is surgically placed into the vena cava via a femoral or jugular venotomy. Oxygen (O2) is pulled through the hollow fibers by a vacuum pump controlled by a flow meter. There is no extracorporeal circulation of blood. Gas exchange occurs as the patient's blood flows over several hundred hollow fibers. Inlet and outlet gas conduits exit a small skin incision for inflow of O2 and outflow of CO2. Studies in sheep and humans show that the IVOX can support approximately 30% of gas exchange requirements. The position of the IVOX in the vena cava does not affect hemodynamics or cause thromboembolic complications. It can remain in place for up to 22 days without affecting hematologic or blood chemistry parameters. The IVOX is currently undergoing clinical trials at selected medical centers in patients with acute respiratory failure.

Adolescent↗
PubMed1991

A fluoxetine-induced frontal lobe syndrome in an obsessive compulsive patient.

The authors report the occurrence of apathy, indifference, inattention, and perseveration in an obsessive compulsive patient taking high doses of fluoxetine. These changes were associated with a decrease in cerebral blood flow in the frontal lobes and changes in neuropsychological tests generally associated with frontal lobe impairment. These clinical manifestations disappeared 4 weeks after discontinuation of fluoxetine.

Adult↗
PubMed1990

Plan and operation of the NHANES I Epidemiologic Followup Study, 1986.

This report describes the plan and operation for the 1986 data collection wave of the Epidemiologic Followup to the First National Health and Nutrition Examination Survey (NHANES I). Tracing and data collection were conducted on 3,980 persons 55-74 years of age at NHANES I who were not known to be deceased in the 1982-84 data collection wave of the NHANES I Epidemiologic Followup Study.

Aged↗
PubMed1989

Airborne bacteria and viruses.

Coughing, sneezing, talking, bed-making, turning pages of books, etc. all generate microbial aerosols which are carried and dispersed by air movements. Inhalation of these particles may cause allergic responses but whether or not infectious disease ensues depends in part on the viability and infectivity of the inhaled microbes and their landing sites. Desiccation is experienced by all airborne microbes; gram-negative bacteria and lipid-containing viruses demonstrate phase changes in their outer phospholipid bilayer membranes owing to concomitant changes in water content and/or temperature. These changes most likely lead to cross-linking reactions of associated protein moieties principally at mid to high relative humidity (RH). For lipid-free viruses these reactions of their surface protein moieties occur most rapidly at low RH. Radiation, oxygen, ozone and its reaction products and various pollutants also decrease viability and infectivity through chemical, physical and biological modification to phospholipid, protein and nucleic acid moieties. The extent of damage and the degree of repair together with the efficacy of host defence mechanisms largely controls whether the causative microbes take hold and spread disease via the airborne route. At least indoors, where desiccation is the predominant stress, the general reversibility of membrane-phase changes by vapour-phase rehydration when coupled with efficacious microbial enzymatic repair mechanisms under genetic control, virtually ensures the spread of disease by the aerobiological pathway.

Aerosols↗
PubMed1978

Quantitative studies on the development of the bronchi and bronchial glands of the pig from birth to maturity.

Cross-sectional areas of bronchi and bronchial glands of pigs aged from 1 day to 10 months were measured using image analysis. Growth of the bronchial glands was slow for the first month of life, reached a maximum between 1 and 3 months, and slowed again after 5 months. Mucous gland sizes fell into two groups, one included the apical, cardiac and accessory lobes, the other the diaphragmatic lobes. From birth to maturity the percentage increase in mucous gland area of all lobes was very similar. For the anterior lobes, mucous glands and bronchial lumina grew in direct proportion to each other. Up to 1 month of age the bronchial lumina of the diaphragmatic lobes grew but the glands did not. Later, glands and lumina grew in direct proportion. From birth to maturity the percentage increase in bronchial cross-sectional area was similar for all lobes.

Age Factors↗
PubMed1976

Inactivation kinetics of some microorganisms subjected to a variety of stresses.

Loss of viability in aerosols of Escherichia coli B, E. coli commune, E. coli Jepp (in nitrogen atmospheres), and Semliki forest virus (in air) was determined as a function of relative humidity at 26.5 C. The decay patterns could be accounted for accurately by means of an equation derived from a postulated mechanism involving population distributions and first-order denaturation kinetics. Analyses of published curves describing loss of viability (all of which were semiexponential, ie., J-shaped) for various microorganisms stressed by different techniques showed that the proposed mechanism also provided an explanation for effects of the following factors (in the absence of open air, oxygen, or radiation): (i) influence of relative humidity upon aerosol susvival; (ii) dissemination of aerosols from the wet and dry states; (iii) protecting additives; (iv) relative humidity change before reconstitution; (v) reconstituting fluids; (vi) water content of freeze-dried product; (vii) storage gas; and (viii) storage temperature. The date indicate that low temperatures and high pressures were likely to be conducive to the preservation of viable bacteria and viruses, provided that cold shock and decompression shock were absent.

Aerosols↗
PubMed1976

Effects of isoprenaline and pilocarpine on salivary glands as assessed by gravimetric and image analysis techniques.

Pigs were given 6 daily injections of isoprenaline or pilocarpine. At necropsy the parotid, submaxillary and sublingual salivary glands were removed and weighed. Histological sections were prepared from several regions of each gland and the cross-sectional area of their acini was measured in treated and control animals by means of a Quantimet Image Analysis System. Both isoprenaline and pilocarpine produced a significant increase in the weight of the parotid and submaxillary glands, which was accompanied by an increase in acinar area. There was no change in the weight of the sublingual gland with either drug, but isoprenaline did induce an increase in the area of sublingual acini. A comparison is made of the changes in weight and structure of the salivary glands as shown by these methods.

Animals↗