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Biomedical subjects

D L Ross

Publications and source records attributed to D L Ross.

140 records · Page 8Linked to original sources

Cardiac arrest.

Cardiac arrest is easily recognized clinically and requires immediated cardiopulmonary resuscitation (CPR) by well trained personnel. The importance of prophylaxis is emphasized in high risk patients. The ABC regime of CPR and the technique of blind defibrillation are recommended in the management of cardiac arrest. Good results may be expected with ventricular fibrillation associated with some correctable factor or myocardial infarction. With a satisfactory CPR technique and prompt resuscitation, the incidence of complications is low.

Adult↗

Early biochemical and EEG correlates of the ketogenic diet in children with atypical absence epilepsy.

Early changes in blood chemistry and the electroencephalogram were monitored during the first three hours after initiating the medium chain triglyceride (MCT) diet in nine children with intractable atypical absence seizures. Serum glucose, insulin, triglycerides, cholesterol, free fatty acids, ketone bodies concentrations, and venous pH were assayed before and at timed intervals after MCT oil was administered orally. The concentration of serum ketones rose progressively over three hours, beta-hydroxybutyrate proportionately higher than acetoacetate. A statistically significant decrease in the group mean number of epileptiform discharges occurred following MCT therapy. Seizure frequency decreased by more than 50 percent in two-thirds of the children during the 10 week treatment period.

Adolescent↗

Reduction of elevated CSF beta-endorphin by fenfluramine in infantile autism.

Fenfluramine therapy has been reported to improve behavior in infantile autism and has been associated with a decrease in abnormally increased blood serotonin content. The primary central effect has not been proved to be serotonergic. Beta-endorphin is involved in the anorexic effect of fenfluramine and may play a role in autism. Nine children with infantile autism were treated with fenfluramine in double-blind, placebo-crossover design. Transient anorexia was the only adverse effect. Autistic behavior was reported to improve in three patients, but objective psychometric tests were unchanged. Beta-endorphin-like immunoreactivity was determined in lumbar cerebrospinal fluid of patients during and before or after treatment with fenfluramine and then was compared to normal controls. Beta-endorphin was elevated significantly in the baseline autistic group (p less than .005) and was reduced toward control values during fenfluramine treatment. The results are consistent with a role for beta-endorphin in infantile autism and in the mechanism of fenfluramine treatment.

Autistic Disorder↗

Do trauma scores accurately predict outcomes for patients with burns?

A highly refined quality assurance program relies on accurate outcome evaluations and the identification of patients who are truly worthy of peer review. In our hospital, the Glasgow Coma Score, the Trauma Score, and the Injury Severity Score are used to monitor patients with burns. A retrospective review of 511 admitted patients with burns was performed to determine whether the existing monitors (Trauma Score, Glasgow Coma Score, Injury Severity Score) or the use of the Baux Score, the Edlich Burn Score, and the Zawacki Score would provide a more precise monitoring system. Logistic regression techniques demonstrated that the Baux Score, the Edlich Burn Score, and the Zawacki Score were highly correlated with patient outcome (p less than 0.001). Linear regression techniques demonstrated that only the Baux Score, the Edlich Burn Score, and the Zawacki Score were correlated with length of stay (p less than 0.01). On the basis of this retrospective review, the Baux Score, the Edlich Burn Score, and the Zawacki Score more accurately predicted outcomes for patients with burns than did the Trauma Score, the Injury Severity Score, and the Glasgow Coma Score; these scores can thus provide the most valuable information for quality assurance activities.

Adult↗

Prognostic implication of ST-segment resolution following primary percutaneous transluminal coronary angioplasty for ST-elevation acute myocardial infarction.

BACKGROUND: ST-segment changes have been shown to correlate with myocardial tissue perfusion. Complete ST-segment resolution after thrombolysis in acute myocardial infarction is associated with lower mortality and better left ventricular function. Primary percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction restores better epicardial coronary flow to the infarct-related artery than thrombolysis. However, ST changes may persist and flow can remain poor despite a patent vessel. AIM: To examine the prognostic implication of ST-segment resolution immediately following primary and rescue PTCA for ST-elevation acute myocardial infarction (STEMI). METHODS: Records of 201 consecutive primary and rescue PTCA performed at Westmead Hospital for STEMI from January 2000 to December 2001 were reviewed. ST-segment elevation (taken 20 ms after the end of the QRS complex) was measured immediately before and after the procedure. ST-segment resolution of greater than 70% after the procedure was considered as -'complete' ST-segment resolution, whereas ST-segment resolution of less than 70% was considered as 'incomplete' ST-segment resolution. RESULTS: Of the 201 patients, 117 (58%) had complete ST-elevation resolution and 84 (42%) did not. There was a significant difference in survival free of major adverse cardiovascular events; 60% of those with complete ST-segment resolution were event-free at 2 years compared with 35% of those patients without complete ST-segment resolution. CONCLUSION: ST-segment resolution after primary and rescue PTCA for STEMI is associated with significantly higher event-free survival. The goal of primary angio-plasty should be the restoration of normal epicardial flow with normalization of ST-segments.

Angioplasty, Balloon, Coronary↗