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Biomedical subjects

D Gross

Publications and source records attributed to D Gross.

At least 181 records · Page 10Linked to original sources
PubMed1979

Assessing the need for follow-up: the relationship of prognosis to posthospitalization adjustment.

Parents of children (N-64) hospitalized at a psychiatric hospital between the years 1971 and 1976 rated their child's adjustment in a number of behavioral areas. Problems in school, making friends, acting age-appropriately, and handling aggression were reported to be the major sources of difficulty for 40% of the former patients. No statistical relationship was found between clinicians' prognosis at discharge and children's post-hospitalization adjustment. The authors discuss some of the variables that mitigate against accurate outcome prediction and argue for the integration of an organized follow-up program into their treatment program.

Adolescent↗
PubMed1979

Electromyogram pattern of diaphragmatic fatigue.

We studied the effect of breathing at various levels of transdiaphragmatic pressure (Pdi) on the EMG power spectrum of the diaphragm. The diaphragmatic EMG was measured simultaneously with a bipolar esophageal electrode (EE) and surface electrode (SE) placed on the ventral portion of the sixth and seventh intercostal spaces in five normal subjects breathing at functional residual capacity (FRC) against an inspiratory resistance. During each fatigue run the subjects generated a Pdi, with each inspiration, that was 25, 50, or 75% of maximum Pdi (Pdimax) for a period up to 15 min. During runs at 50 and 75% of the Pdimax, which are known to produce fatigue, we found for both EE and SE a progressive increase in the amplitude of the low-frequency (L = 20-46.7 Hz) and a decrease in the high-frequency (H = 150-350 Hz) component of the EMG. These changes were not seen at 25% of Pdimax. The diaphragmatic H/L ratio was independent of Pdi when the diaphragm was not fatigued. H/L fell while the diaphragm performed fatiguing work and this was more rapid at higher Pdi's. It was thus concluded that frequency spectrum analysis of the EMG can detect diaphragmatic fatigue reliably, prior to the time when the diaphragm fails as a pressure generator.

Diaphragm↗
PubMed1979

Fatigue of inspiratory muscles and their synergic behavior.

The time (tlim) required to produce inspiratory muscle fatigue was measured in five normal subjects breathing at functional residual capacity (FRC) against a variety of high inspiratory resistive loads. In every breathing test the subjects generated with each inspiration a mouth pressure (Pm) that was a predetermined fraction of maximum Pm (Pmmax). They continued breathing until they were unable to generate this Pm. The Pm/Pmmax that could be generated indefinitely (Pmcrit) was around 60%. The inspiratory power output at that level of breathing was 6.6 kg.m/min (Wcrit). In three of those subjects the same experiment was conducted at an end-expiratory volume of FRC + one-half inspiratory capacity (1/2IC). The higher lung volume was actively maintained by the subjects watching end-expiratory transpulmonary pressure on an oscilloscope. For any fraction of the maximum mouth pressure at FRC + 1/2IC (Pm'max), tlim was shorter than FRC. Pmcrit decreased to 30% Pm'max and Wcrit to 2.6 kg.m/min. Monitoring the abdominal pressure revealed that the contribution of the diaphragm and intercostal accessory muscles alternated in time, possibly postponing the onset of fatigue.

Diaphragm↗
PubMed1978

[Diagnostic and therapuetic local anesthesia in facial neuralgia (author's transl)].

Diagnostic and therapeutic local anesthesias (DLA and TLA) in experienced hands are also an important method first of establishing the cause of certain facial neuralgias and then of treating them successfully. Diagnostic and therapeutic local anesthesias presuppose a thorough examination of all factors which may arise in a particular facial neuralgia. If local anesthesia reveals a peripheral cause for the facial neuralgia concerned, a lasting relief of pain can then be obtained through extinction of the source of pain so that the body can restore, at first temporarily and under certain circumstances after consistent repetition of therapeutic local anesthesia at the same spot continuously, the disordered functions in this area (dysesthesia, dyskinesia, dyscrasia, dysthymia). DLA and TLA are only one method of peripheral neurotherapy.

Anesthesia, Conduction↗
PubMed1978

Partitioning of inspiratory pressure swings between diaphragm and intercostal/accessory muscles.

We tested the hypothesis that the inspiratory pressure swings across the rib-cage pathway are the sum of transdiaphragmatic pressure (Pdi) and the pressures developed by the intercostal/accessory muscles (Pic). If correct, Pic can only contribute to lowering pleural pressure (Ppl), to the extent that it lowers abdominal pressure (Pab). To test this we measured Pab and Ppl during during Mueller maneuvers in which deltaPab = 0. Because there was no outward displacement of the rib cage, Pic must have contributed to deltaPpl, as did Pdi. Under these conditions the total pressure developed by the inspiratory muscles across the rib-cage pathway was less than Pdi + Pic. Therefore, we rejected the hypothesis. A plot of Pab vs. Ppl during relaxation allows partitioning of the diaphragmatic and intercostal/accessory muscle contributions to inspiratory pressure swings. The analysis indicates that the diaphragm can act both as a fixator, preventing transmission of Ppl to the abdomen and as an agonist. When abdominal muscles remain relaxed it only assumes the latter role to the extent that Pab increases.

Diaphragm↗
PubMed1977

[Multifactorial diagnosis and treatment of low back pain (author's transl)].

As a rule chronic or acute low back pain has not one, but a number of pathogenetic factors. Disturbances of the supporting and locomotor systems, the cerebrospinal and autonomic nervous systems, the viscera, posture and the psyche are to be recognized and delimited. The therapeutic aim is the extinction, suppression or elimination of disturbing factors in the supporting and locomotor systems, in the peripheral voluntary and autonomic nervous systems and the psyche, in order to enable the organism to regain its normal functions at all levels as far as possible. After successful treatment we will have to see to the maintenance and stabilization of the regained functions. Here exercising and supporting procedures have their place in the somatic and psychic areas.

Anesthesia, Local↗