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Biomedical subjects

E Miller

Publications and source records attributed to E Miller.

At least 361 records · Page 20Linked to original sources
PubMed1984

Objective evaluation of clinical performance and correlation with knowledge.

In certifying competence of anesthesiologists who have finished residency training, knowledge and judgment are evaluated objectively using written and oral examinations. Clinical motor skills, however, are not routinely assessed by objective techniques. This implicitly assumes that knowledge and judgment correlate with performance of motor skills. This study was designed to evaluate whether performance of a particular motor skill correlates with performance on a knowledge test related to that skill. To do this, we developed a criterion-referenced Spinal Anesthesia Skill Test and a knowledge test using multiple-choice questions related to spinal anesthesia. Both the skill and knowledge tests were administered to 44 residents at various levels of training at five major anesthesia teaching programs. Scores on the skill test were significantly higher than in the knowledge test, suggesting that proficiency in this essential motor skill is achieved earlier in training. There was no correlation between scores on the skill test and knowledge test. There were institution-linked differences in the scores on the skill test, suggesting that teaching of motor skills is not uniform. The advantages of developing criteria of performance of motor skills is discussed.

Anesthesia, Spinal↗
PubMed1983

Chronoamperometry in brain slices: quantitative evaluations of in vivo electrochemistry.

Practical utilization of in vivo electrochemistry for brain studies has been impeded by difficulties with specificity and quantitative measurements. Studies in brain slices combined with similar data from intact animals have provided important new information on the nature of the electrochemical studies. Using the enzyme ascorbic acid oxidase (AAO), the primary signal contribution has been calculated to come from ascorbic acid. By inhibiting monoamine oxidase activity with pargyline, the second most important contributor in caudate extracellular fluid is postulated to be 3,4-dihydroxyphenylacetic acid. These species are calculated to constitute over 93% of the observed oxidation current in rat caudate extracellular fluid.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1983

Distribution of 14C-labelled acrylamide and betaine in foetuses of rats, rabbits, beagle dogs and miniature pigs.

[14C]Acrylamide and [14C]betaine hydrochloride were administered in a single iv dose to pregnant rats, rabbits, beagle dogs and miniature pigs late in gestation (1-2 days before expected parturition). Dosages used were 10 mg/kg for rats and 5 mg/kg for the other species. The compounds were allowed to equilibrate in the animal (for 1 hr in rats and for 2 hr in the other species); the dam was then killed and the foetuses were removed by caesarean section. Each foetus was weighed and analysed for radioactivity, either by homogenization of the whole foetus (rat and rabbit) or by determining separately the radioactivity in individual organs and tissues (dog and pig). Foetal uptake of the polar compound betaine hydrochloride was much lower than that of the more lipophilic acrylamide. The sex of the foetus did not appear to affect uptake of either compound. There were no significant differences in total uptake of isotope attributable to the position of the foetus within the uterus in any of the four species given either acrylamide or betaine. Similarly, uterine position did not affect the uptake of acrylamide or betaine by individual tissues of foetal dogs or pigs. Since the distributions of 14C-labelled acrylamide and betaine hydrochloride were essentially uniform throughout a litter, it would not be necessary to sample all of the members of a litter to obtain a representative picture of foetal distribution.

Acrylamides↗
PubMed1983

Pyrexia after diphtheria/tetanus/pertussis and diphtheria/tetanus vaccines.

The temperatures of 587 children were taken before and after diphtheria/tetanus/pertussis (DTP) or diphtheria/tetanus (DT) vaccine. Only slight temperature increases were found but these were notably more frequent after plain than adsorbed DTP vaccine preparations and the frequency increased with each successive dose.

Diphtheria Toxoid↗
PubMed1983

No deleterious pulmonary effects from moderate transfusions of microaggregate-rich blood in dogs.

Dogs were transfused with moderate amounts of blood (28% of calculated blood volume) containing microaggregates as reflected in high screen filtration pressure. In one group of animals, the blood was filtered through a standard commercial filter and in another group a micropore transfusion filter was used. Comparison of the transfused groups with nontransfused control animals revealed a statistically significant decrease in Qt and pH 1 h after blood transfusion. There were no differences between the two transfused groups. It is concluded that moderate blood transfusions with aggregate-rich blood did not seem to seriously compromise lung function. Furthermore, the changes found after transfusion were related to the presence of factors in stored blood other than microaggregates.

Animals↗
PubMed1983

Fat embolism prophylaxis with corticosteroids. A prospective study in high-risk patients.

The efficacy of corticosteroid treatment in the prophylaxis of the fat embolism syndrome was evaluated in a prospective, randomized, double-blind study of high-risk patients with long-bone fractures. Using a set of objective diagnostic criteria, we saw a significant difference in the incidence of the syndrome between corticosteroid- (0 of 21) and placebo-treated patients (9 of 41) (p less than 0.05). There were no complications related to corticosteroid treatment. No routine laboratory or physical findings reliably predicted the development of the fat embolism syndrome except petechial rash, which occurred only in 5 placebo-treated patients who developed the syndrome. Complement activation was present in all patients studied who had the syndrome (5 of 27) but also in many patients who did not meet our diagnostic criteria, suggesting a multifactorial cause. These data support the prophylactic value of corticosteroid treatment in patients at high risk for the fat embolism syndrome, particularly if several unfavorable predictors are present.

Adolescent↗
PubMed1983

The effects of hemoglobin supplements on maximal oxygen uptake in females.

There was no significant change in the maximal oxygen uptake for either the experimental or the control group from the pre-test to the post-test. Five blood chemistry measures were unable to predict the post-maximal oxygen uptake scores using the procedure of stepwise regression. An examination of the blood chemistry profiles indicated that sports anemia did not occur. The factorial breakdown was unable to produce any significant insight into the changes in hemoglobin concentration and oxygen consumption. Heme-iron supplementation was unable to override the regulatory system of the body and allow the hemoglobin level to become elevated.

Adult↗
PubMed1982

Consequences of confirmed maternal rubella at successive stages of pregnancy.

Over a thousand women with confirmed rubella infection at different stages of pregnancy were followed up prospectively. Two-thirds of the women were multiparous. Pregnancy continued in 40%, and the infants were followed up after birth both clinically and serologically. The frequency of congenital infection after maternal rubella with a rash was more than 80% during the first 12 weeks of pregnancy, 54% at 13-14 weeks, and 25% at the end of the second trimester. The infection rate then rose again to reach a high figure in the last month. Follow-up was to 2 years of age--the findings in infected children being compared with those in children who had escaped infection. Rubella defects occurred in all infants infected before the 11th week (principally congenital heart disease and deafness) and in 35% of those infected at 13-16 weeks (deafness alone). No defects attributable to rubella were found in 63 children infected after 16 weeks. Continued surveillance of cases of confirmed rubella during pregnancy is recommended as an additional way of monitoring the effect of rubella vaccination.

Antibodies, Viral↗
PubMed1982

Steroid therapy following isolated smoke inhalation injury.

Steroids have no positive influence upon pulmonary related morbidity and mortality following combined smoke inhalation and thermal cutaneous injury (3, 4). Steroid administration following isolated smoke inhalation without concomitant thermal cutaneous injury has, however, been shown to have beneficial effects in previous animal studies (1). This potential therapeutic approach to treatment has not been examined in the clinical setting. Recent hotel fires in Las Vegas, Nevada, resulted in a large cohort of individuals with similar smoke exposures without associated injuries. Two of four hospitals in the triage system administered steroids following injury. Patients were divided into two groups, a steroid-treated, and a non-treated group. These groups were compared using multivariate and frequency analyses. There were no detectable differences in sex, signs, symptoms, and previous medical history. There were likewise no differences between groups with respect to oxyhemoglobin saturation, arterial oxygen tension, arterial pH, and pulmonary-related morbidity and mortality. These data suggest that steroid coverage has little beneficial effect upon pulmonary-related morbidity and mortality following isolated smoke inhalation injury.

Adrenal Cortex Hormones↗
PubMed1982

Reality orientation: a critical appraisal.

Reality orientation is now extensively used with psychogeriatric patients. The evidence for its effectiveness is reviewed and the underlying philosophy and assumptions are critically examined. Whilst reality orientation does appear to have some effect, the benefits are small and restricted in range. It can be argued that it is not directed at the most appropriate therapeutic goals. Reality orientation should be seen as the starting point for the development of more effective intervention techniques for use with this client population and not as an end in itself.

Aged↗
PubMed1982

Effect of copper on carbohydrate metabolism in rats.

Rats fed a copper-poor diet were found to have a reduced plasma insulin response to an oral glucose load in comparison with rats fed a copper-supplemented diet. In addition, the increment in plasma glucose above the fasting level at 60 min and at 120 min was significantly higher in rats maintained on the copper-poor diets. In vitro glucose incorporation into diaphragm glycogen and into epididymal fat-pad lipids was stimulated greater than twofold by the addition of 100 micrograms/ml CuCl2 to the incubation medium. In tissues of streptozotocin-diabetic rats, the stimulatory effect of copper on glucose incorporation in vitro was also noted, but was significantly smaller. These results indicate that glucose utilization by peripheral tissues and insulin release may be added to the many vital functions for which copper is essential.

Animals↗