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Biomedical subjects

D Denno

Publications and source records attributed to D Denno.

10 recordsLinked to original sources
PubMed1995

Aggressive fluid resuscitation and broad spectrum antibiotics decrease mortality from typhoid ileal perforation.

One of the most severe complications of typhoid enteritis is perforation of ileal ulcerations. The typically high mortality rates from these perforations are in part due to extremely limited supportive care in hospitals in typhoid endemic areas. In the setting of a rural African hospital, this study demonstrated a decrease in overall mortality rate from 40% with one layer closure and chloramphenicol alone to 19% with two-layer closure and chloramphenicol, gentamicin and metronidazole. This was primarily due to a decrease in late (> 24 h) mortality. There was also a decrease in overall mortality rate from 43% with < 10 ml/kg of intraoperative fluid administration to 14% with > 10 ml/kg. This was primarily due to a decrease in early (< 24 h) mortality. Even within the constraints of the rural developing world, more aggressive initial fluid resuscitation can decrease early mortality, while broader spectrum antibiotics and two-layer closure can decrease late mortality from typhoid ileal perforation.

Adolescent↗
PubMed1995

Admissions for injury at a rural hospital in Ghana: implications for prevention in the developing world.

OBJECTIVES: Strategies for injury prevention have been extensively studied in developed nations but not in the developing world. This study sought to determine which mechanisms of injury were common in a rural developing area and which were important contributors to mortality and disability. METHODS: All 614 patients admitted for injuries to a rural African hospital between 1987 and 1991 were analyzed retrospectively for mechanism of injury and outcome, as assessed by mortality and long-term functional status. RESULTS: The leading mechanisms of injury were transport related (29%) and burns (16%). Burns accounted for 61% of injuries in children under 5 years. Mortality was 7.3% in the series, with 24% of deaths owing to transport injuries. Disability developed in 103 (22%) of the 462 survivors available for assessment, with most disability resulting from transport injuries (26% of all disabilities), burns (13%), and agricultural injuries (14%). CONCLUSIONS: Among injured patients who presented for treatment in this rural developing area, the largest burden of mortality and disability was from burns and transport-related injuries. Population-based studies are needed to substantiate whether these should be priorities for injury prevention efforts.

Adolescent↗
PubMed1993

Paediatric trauma in the rural developing world: low cost measures to improve outcome.

We reviewed 181 injured children admitted to a rural African hospital from 1987 to 1990 to ascertain factors influencing survival and functional outcome. Burns were the most common (39 per cent), occurred in the youngest patients, and were due to domestic scalding in 54 per cent of cases. Of the patients, 65 per cent presented more than 24 h after injury and 81 per cent presented without any previous treatment. Major disability occurred in 14 per cent of survivors and was associated with Injury Severity Score (ISS), extremity injury, and delayed presentation. Mortality was associated with the ISS. The mean ISS was 6.3. An ISS of 20-25 was associated with 75 per cent mortality. Trauma caused 8 per cent of hospital deaths in the 5-19 years age group. To reduce the mortality and disability from paediatric trauma in the rural developing world, we recommend: (i) prevention strategies targeting domestic burns in younger children, (ii) increased attention to care of extremity injuries and burns, and (iii) increased use of non-medical health care providers in more remote areas.

Adolescent↗
PubMed1987

Birth stress and lateral preferences.

Conflicting evidence exists concerning the possible role of birth stress in the etiology of left-sided lateral preferences. In order to clarify this issue, associations among lateral preferences of hand, eye, and foot and eight indices of prenatal and perinatal stress were examined in the present study on a sample of 987 boys and girls who participated in the Philadelphia Collaborative Perinatal Project. Controls were instituted for some of the methodological and measurement problems encountered in past birth stress and laterality research. Results showed that subjects with different lateral preferences did not differ significantly in their distributions of all but one birth stress items. Hence, there was no substantial evidence for a link between birth stress and left-sided preferences. Alternative hypotheses for the etiology of left-sidedness should therefore be explored.

Apgar Score↗
PubMed1986

Birth order and lateral preferences.

Associations between birth order and lateral preferences of hand, eye and foot were examined in a sample of 6436 black seven year old boys and girls whose mothers participated in the Collaborative Perinatal Project (CPP) in Philadelphia. Overall, most of the subjects (87%) showed right hand preference, and the majority of subjects showed right eye (55%) and foot (63%) preferences. Analysis of cross preferences indicated some tendency for a consistent right side orientation. However, patterns of lateral preferences were similar for both boys and girls across seven birth order groups. The data were interpreted as showing that birth order and lateral preferences are not interrelated.

Black or African American↗
PubMed1985

Affinity chromatographic purification of antibody subsets depends on the mode of cross-linking of antigen to the affinity matrix.

Affinity columns for the separation of rabbit antibodies (Abs) to the purified nicotinic acetylcholine receptor (AcChR) from Torpedo californica electroplax were constructed in two ways: (1) by direct cross-linking of purified AcChR to cyanogen bromide activated Sepharose 4B, and (2) by first cross-linking a purified curarimimetic neurotoxin to cyanogen bromide activated Sepharose 4B, subsequently saturating with AcChR, and finally cross-linking the toxin to noncovalently bound receptors with bisimidate cross-linkers such as dimethyl suberimidate (DMS). Ab(AcChR) from pooled rabbit antisera were chromatographed in near stoichiometric proportions to the AcChR bound to the column to allow equilibrium selection of antibodies directed against sites which were not sterically hindered. The concept that columns of the second type subfractionate Ab(AcChR) was tested by analyzing Ab(AcChR) from column fractions with an ELISA and radioimmunoassay (RIA) procedure. The ELISA was constructed to that the exposed face of the AcChR was the same as that expected for columns of the second type, i.e. for the internal or cytoplasmic face. Enhanced ratios of ELISA to RIA measures of Ab(AcChR) reflected substantial purification of cytoplasmic face antibodies in DMS-cross linked columns. Total Ab(AcChR) was measured by RIA. Both types of columns gave substantial purification of tightly bound antibodies, i.e. those which were eluted with 3M potassium thiocyanate. Thirty-fifty percent of the IgG eluted was found in these fractions, which contained 2-6% of the total eluted protein. Approximately half of the total IgG present in these fractions represented specific IgG against AcChR. Both types of columns could be reutilized giving similar results; however, their efficiency was diminished.

Animals↗
PubMed1983

Lateral preferences of hand, eye and foot: relation to cerebral dominance.

Patterns of lateral preferences of hand, eye and foot were analyzed on 7364 children, differing in race (black and white) and sex. Right hand and foot preferences were found in over 80%, and right eye preferences were found in over 50% of the subjects. No sex or race differences appeared in left-right preferences. However, significantly more females than males, and more blacks than whites, showed variable foot preference. Further analyses of cross preferences indicated that about 40% of the subjects showed consistent lateral preferences of hand, eye, and foot (about 37% right, and about 3% left), whereas the other 60% were divided among ten groups of different preference combinations. The three lateral measures were correlated to differing degrees. The data were interpreted as showing the effects of cerebral dominance on lateral preferences of hand, eye and foot. The effects seemed to be considerably stronger for hand and foot than for eye preferences. Due to a lack of supporting data, interpretation of race differences in variable foot preference must be considered tentative.

Black or African American↗
PubMed1982

Early cognitive functioning: sex and race differences.

Six scales of early cognitive functioning were administered at three times (eight months, four and seven years) to 3013 black and white, male and female children. Hypotheses addressed the nature and extent of longitudinal sex differences in cognitive abilities among racial groups varying in physical maturation. Controlling for selected socioeconomic influences, a slight sex by race interaction was found at four and seven years. Generally, white females scored somewhat lower on cognitive tests than white males, whereas black females scored equivalently or somewhat higher than black males. Test score differences among the four sex and race groups were more apparent in seven-year spatial abilities relative to verbal abilities. Findings are discussed in terms of possible maturational and environmental influences on cognitive abilities among different sex and race groups.

Child↗