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Biomedical subjects

D R Grant

Publications and source records attributed to D R Grant.

At least 73 records · Page 4Linked to original sources
PubMed1985

Empyema: analysis of treatment techniques.

Empyema is associated with a high mortality. To study the factors responsible for the failure of treatment, the authors reviewed 90 cases of nontuberculous thoracic empyema seen at the University of Western Ontario in London, between 1970 and 1980. The most common causes of empyema were bronchopulmonary infections (63%), complications of pulmonary surgery (14%) and secondary infections of hydrothoraces or hemothoraces (13%). In 51 patients (57%) the condition was acquired in hospital or was related to previous medical therapy. Nine cases were recognized only at autopsy. The treatment of empyema was assessed in 81 patients, who received an average of 2.2 antibiotics during the course of treatment. Five patients received antibiotics as the only therapy; one died. Seventy-two patients were treated by surgical drainage; 35 (49%) were cured and 18 (25%) subsequently died. Twelve of 18 decortication procedures were successful including 4 performed as a primary procedure and 8 as a secondary procedure. Five of seven patients who underwent thoracoplasty were cured. The overall mortality in the series was 23%. Prevention and early recognition of empyema may reduce the mortality. Patients who do not improve promptly with surgical drainage may benefit from early decortication.

Adolescent↗
PubMed1984

Intraadrenal steroid concentrations in man: zonal differences and developmental changes.

Adrenal gland samples from 34 individuals 0-68 yr of age were dissected into four layers of equal thickness parallel to the capsule and the zonal boundaries of the cortex, and were analyzed by RIA for their concentrations of 17OH-progesterone, 11-desoxycortisol, cortisol, progesterone, corticosterone, aldosterone, 17OH-pregnenolone, dehydroepiandrosterone, androstenedione, and testosterone, with DNA content to correct for variations in sample size. Intraadrenal steroid concentrations were 10-1000 times higher than reported serum levels, and varied significantly with age, adrenal weight, and cortical thickness. The concentrations of cortisol,11-desoxycortisol, corticosterone, androstenedione, and testosterone increased with age. Levels of 17OH-pregnenolone, dehydroepiandrosterone, and 17OH-progesterone decreased during infancy in parallel with involution of the adrenal, and then rose again in late childhood and puberty. The concentrations of all steroids, except aldosterone, increased significantly from the outer to the inner layers of cortex. Comparisons of product-substrate ratios suggested that changes in adrenal androgen secretion are induced by shifts in the relative activities of key branch-point steroidogenic enzymes, notably 3 beta-hydroxysteroid dehydrogenase-isomerase and 17,20-desmolase. Since intraadrenal steroid concentrations are in the range of the Michaelis-Menten constant (Km) for these enzymes (10(-6) M) and can be shown in vitro at this concentration to influence relative enzyme activities, these data support the hypothesis that zonal and developmental changes in adrenal androgen secretion relative to that of cortisol are induced by changes in the steroidal micro-environment which in turn are imposed by adrenal growth and the centripetal blood flow through the gland.

17-Hydroxysteroid Dehydrogenases↗
PubMed1981

A classification system to meet today's needs.

Patient classification systems hold the promise of providing nursing services with objective and scientific means to identify acuity levels and project staffing requirements. Nursing administrators have an obligation to base nurse staffing on objective documentation. To ensure the cooperation of nursing staff, they must make the classification system meaningful to staff and patient care goals. A classification system based on accurate and objective assessment of patient acuity levels will enable administrators to use their most valuable resource--their nursing staff--efficiently and effectively.

Classification↗
PubMed1966

Pilot study for a diabetes detection program based upon rapid glucose microanalysis of postprandial capillary blood.

A pilot study was undertaken for a diabetes detection program based upon quantitative microanalysis for glucose of postprandial finger-tip blood from subjects attending a tuberculosis preventive survey. A glucose level of over 120 mg./100 ml. was regarded as a positive screen test. Fifty of the 967 subjects in the pilot study had positive tests. Ten of these were excluded from follow-up because of age and a borderline screen test, and eight refused follow-up or could not be traced. Glucose tolerance tests on the remaining subjects who "screened" positive indicated that 1% of the original number had had false-positive screen tests, while 1% were diabetic and 0.5% were possibly diabetic. These data indicate that this screening method is sufficiently sensitive to detect most of the individuals with undiagnosed diabetes in the population, without picking up an undue number of subjects who have slight abnormalities of glucose metabolism without known clinical significance.

Adult↗