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Biomedical subjects

E Moss

Publications and source records attributed to E Moss.

At least 73 records · Page 4Linked to original sources
PubMed1980

Obstetric epidural analgesia and postural hypotension.

Supine and erect arterial pressures were measured daily for six to seven days after delivery in 100 patients, of whom 50 had received epidural analgesia. There was no difference in the magnitude of postural hypotension between the epidural and control groups on any day after delivery, although in both groups the hypotension was greater during the first two days due almost entirely to changes in systolic arterial pressure. The incidence of dizziness on standing was similar in both groups (9%). Thus postural hypotension is no more common in women who have received epidural analgesia than in others. All patients should be helped out of bed after delivery, and any patient who experiences dizziness should have her blood pressure measured until the dizziness disappears.

Adolescent↗
PubMed1980

The development of a psychiatric rehabilitation service: a two year pilot project.

In the history of psychiatry, one can discern conflicting trends with regard to hospitalization of people suffering from severe mental disturbances. From the beginning of the 19th century, the standard method for dealing with such people has been to take them away from their homes and work and put them in hospitals. However, since the discovery of antipsychotic drugs in the 1950's, there has developed a new movement to treat mentally disturbed people in their communities, either avoiding hospitalization altogether, or at least greatly shortening it. In many hospitals there has been a synthesis of these two trends, reflected in an upgrading of the importance of the rehabilitation function. In Shalvata Psychiatric Center, a medium-sized psychiatric hospital in Hod Hasharon, Israel, a two-year pilot project to introduce a centralized Rehabilitation Service was recently completed. The present Rehabilitation Service is based on the rehabilitation/activity therapy model in which the hospital is conceptualized as a setting in which patients may develop or recover social and vocational skills needed to function adequately in the community. It has drawn on existing, motivated staff from all mental health professions represented at the hospital, and works closely with all in-hospital wards and the day hospital. The authors discuss six areas of vocational and social rehabilitation with which the Rehabilitation Service has attempted to deal: 1. activity therapy/rehabilitation groups, 2. vocational guidance unit, 3. after-care therapeutic social club, 4. in-hospital rehabilitation consultation, 5. liaison activities with community-based facilities, 6. job placement.

Aftercare↗
PubMed1980

Hemoglobinopathies observed in the population of the Southeastern United States (SE-USA).

A survey of nearly 250,000 citizens of Georgia and South Carolina conducted during the past twenty years has led to the detection of over 40 abnormal hemoglobins and several additional hemoglobinopathies. The presence of some of these hemoglobin abnormalities cause (severe) clinical symptoms but others remain undetected unless a specific search is initiated. The incidence of Hb S varies slightly among the populations of different areas, and appears to be the highest in the coastal counties of Georgia and South Carolina. A survey of over 17,000 persons of mainly high school and college age has shown that a significant number of cases with clinically significant hemoglobinopathies will remain undetected unless such surveys are actively promoted.

Adolescent↗
PubMed1980

The therapeutic club: social rehabilitation of psychiatric patients.

In Israel, where there exists a highly developed network of vocational rehabilitation services for discharged psychiatric patients, there are few organized programs of social rehabilitation. Accordingly, two years Shalvata Psychiatric Center, a medium-sized psychiatric hospital near Tel Aviv, opened a therapeutic social club in its satellite community clinic in the town of Raanana. The authors describe the establishment of the club and various critical facets of the on-going club experience. The club program appears to fulfill a variety of highly important therapeutic needs, and its positive results conform with those reported elsewhere. Among the rehabilitation benefits which can be attributed to such therapeutic clubs are: (1) a rich source of social stimulation, (2) the opportunity to help members improve their repertoire of social skills, (3) the separation of members from their overburdened families several evenings each week, (4) crisis intervention possibilities, and (5) continuous aftercare contact between professional mental health workers and a high risk population. One important result may be the reduction of the re-hospitalization rate among former patients who participate in the club.

Adult↗
PubMed1980

The use of anesthetic drugs to reduce ICP changes in head-injured patients.

Chest physiotherapy causes increases in intracranial pressure (ICP) in patients with severe head injuries. In mechanically hyperventilated severe head injuries (PaCO2 3.3 - 4 kPa) 50% nitrous oxide in 50% oxygen exacerbated ICP increases associated with chest physiotherapy, while thiopentone and Althesin reduced these changes in ICP.

Alfaxalone Alfadolone Mixture↗
PubMed1979

Effect of etomidate on intracranial pressure and cerebral perfusion pressure.

Ten patients with intracranial lesions, anaesthetized with thiopentone and nitrous oxide (70%) in oxygen (30%) received etomidate 0.2 mg kg-1 i.v. Ventilation was controlled in each patient. Intracranial pressure (i.c.p.) and mean arterial pressure (m.a.p.) were recorded. I.c.p. decreased significantly in all patients (0.01 greater than P greater than 0.001). Although PaCO2 decreased during the period of measurement, the extent and time-course of this change suggested that it was not mainly responsible for changes in i.c.p. M.a.p. decreased in most patients, but the decrease was statistically significant only at 3 and 4 min after the administration of etomidate (0.05 greater than P greater than 0.02). The changes in cerebral perfusion pressure (c.p.p.) and heart rate were not clinically or statistically significant. We conclude that etomidate can be used for the induction of anaesthesia in patients with intracranial space-occupying lesions without increasing i.c.p. or seriously reducing c.p.p.

Adult↗
PubMed1979

I.c.p. increases with 50% nitrous oxide in oxygen in severe head injuries during controlled ventilation.

In a randomized trial nitrous oxide 50% in oxygen (Entonox) or oxygen 100% was given during chest physiotherapy on 23 occasions to three mechanically ventilated patients with severe head injuries. Intracranial pressure (i.c.p.) increased by 22.7 mm Hg (SD 10.62) during chest physiotherapy with Entonox, compared with 10.5 mm Hg (SD 10.4) with oxygen 100% (P greater than 0.02). A further nine mechanically ventilated patients with severe head injuries were given Entonox without chest physiotherapy. There was a mean increase in i.c.p. of 3.8 mm Hg (SD 2.4) (P less than 0.001) when Entonox was given, and a mean decrease of 4.6 mm Hg (SD 2.8) when the nitrous oxide was withdrawn. End-tidal carbon dioxide concentration showed almost no change during nitrous oxide administration (decrease of 0--0.1%). We conclude that nitrous oxide causes an increase in i.c.p. in patients with severe head injuries and exacerbates the increases in i.c.p. occurring during chest physiotherapy.

Anesthesia, Inhalation↗
PubMed1979

Oral and pharyngeal cancer in the North-west and West Yorkshire regions of England, and occupation.

Patients with oral or pharyngeal cancer in the two main textile regions of England were matched for age and sex with patients having cancers not known to be associated with textile work. Data were recorded on age, sex, cancer site, and smoking, chewing and drinking habits together with dental and occupational history. There were 102 and 61 matched pairs of males and 52 and 60 matched pairs of females in the North-west and West Yorkshire regions respectively. There were significantly (P less than 0.05) more textile workers in the cases compared with their matched controls for only the females in the North-west. No particular type of textile work occurred more frequently for the cases than the controls in all four matched comparisons. Only for the males in the North-west were there significant differences (P less than 0.05) in the proportions of textile workers in the three cancer sites of the tongue, mouth and pharynx. These results do not confirm the association between textile work and oral or pharyngeal cancer found by the mortality study of Moss and Lee (1974). The results for the association between oral or pharyngeal cancer and smoking, drinking, chewing and wearing of dentures are discussed.

Adult↗
PubMed1978

Effects of tracheal intubation on intracranial pressure following induction of anaesthesia with thiopentone or althesin in patients undergoing neurosurgery.

Intracranial pressure (i.c.p.) and mean arterial pressure (m.a.p.) were studied in 20 patients during the induction of anaesthesia for craniotomy. Tubocurarine was administered as the muscle relaxant and either thiopentone or Althesin for the induction of anaesthesia. No significant differences were found in the i.c.p. changes with induction, intubation or pharyngeal packing, between the thiopentone and the Althesin groups. Except for two patients (one in each group) the increases in i.c.p. associated with intubation were small. In these two patients moderate increases from normal values to 28 and 37 mm Hg were recorded, but in one of these patients coughing and straining followed intubation. Marked decreases in m.a.p. were noted in both groups, but the recovery of m.a.p. was significantly more rapid in the Althesin group. Only two patients had i.c.p. values greater than 20 mm Hg before operation and in neither did i.c.p. increase above control values during induction and intubation. Packing the pharynx produced minimal changes in i.c.p. in all patients.

Adult↗
PubMed1978

Effects of fentanyl on intracranial pressure and cerebral perfusion pressure during hypocapnia.

Ten patients presenting for carniotomy were studied. Each was anaesthetized with thiopentone or Althesin followed by tubocurarine and the lungs were hyperventilated with nitrous oxide in oxygen. Fentanyl 0.2 mg was administered i.v. and the intracranial pressure (i.c.p.) and mean arterial pressure were recorded continuously for 10 min. At the time of administration of fentanyl nine of the 10 patients were hypocapnic (PaCO2 less than 4 kPa). The changes in i.c.p. were small. Cerebral perfusion pressures less than 50 mm Hg were observed in two patients who had moderate hypotension before the drug was given. We conclude that fentanyl is a valuable agent in the hyperventilation technique in patients with intracranial space-occupying lesions, provided that hypotension is absent.

Adult↗
PubMed1978

Chemotherapeutic evaluation of 5-episisomicin (Sch 22591), a new semisynthetic aminoglycoside.

5-episisomicin (Sch 22591) is a novel semisynthetic aminoglycoside with a spectrum and potency similar to gentamicin in its activity against susceptible bacterial strains, but with increased potency against Pseudomonas, Providencia, and Proteus rettgeri. It is also more active than tobramycin and amikacin against these last-mentioned species.Against resistant strains, Sch 22591 is significantly more active than gentamicin or tobramycin. Against resistant gram-negative bacteria other than Pseudomonas, Sch 22591 has activity similar to that of amikacin, but Sch 22591 is more potent. Against Pseudomonas strains, it is active against most gentamicin- and tobramycin-resistant strains and is more active than the other three antibiotics. Some Pseudomonas strains are resistant to Sch 22591, but susceptible to amikacin. Against a selection of aminoglycoside-resistant staphylococci, Sch 22591 has very good activity against strains resistant to tobramycin, amikacin, and gentamicin. The superior in vitro potency of Sch 22591 against Pseudomonas has been confirmed in vivo in experimental infections in mice. Absorption in dogs is similar to that of other aminoglycoside antibiotics. The acute toxicity of Sch 22591 in mice is greater than that of gentamicin; its vestibular toxicity potential and nephrotoxicity potential in cats and rats appear to be similar to those of gentamicin.

Animals↗