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Biomedical subjects

G Blair

Publications and source records attributed to G Blair.

28 records · Page 2Linked to original sources
PubMed1984

Subjective assessment of sleep by Sleep Questionnaire.

A 55-item Sleep Questionnaire is presented for possible use as a standardized instrument in psychological studies of sleep. A factor analysis of responses from 145 adults to the questionnaire indicated 7 factors accounted for 71.7% of the total variance. These factors are congruent with sleep dimensions discussed in the literature and with other factor analytic investigations. A set of 11 clinical judgment scales are also presented. The reliabilities of both factor and clinical scales are adequate as judged by test-retest, internal consistency, and comparisons of self vs spouse ratings. The construct validity is supported by three studies showing significant differences between (a) medical patients with and without sleep disturbances, (b) psychiatric patients with and without symptoms of depression, and (c) short and long sleepers.

Adult↗
PubMed1984

Blunt splenic trauma: diagnosis and management.

To examine the morbidity and mortality associated with blunt splenic injuries, the authors reviewed the results in 106 such patients treated in the Sunnybrook Regional Trauma Unit between June 1, 1976 and June 30, 1983. Initial assessment included peritoneal lavage in 86 patients. No patient with known or suspected splenic injury was treated nonoperatively nor were any patients found to have had splenic injuries missed at the initial assessment. Seventy-one splenectomies and 35 splenorrhaphies were performed. The overall mortality was 25% and 10 surviving patients had serious complications. The splenic injury itself was never the cause of death. Only one patient who initially underwent splenorrhaphy later required splenectomy. It is concluded that blunt splenic injury is rarely the cause of death or serious morbidity when a policy of immediate diagnosis and operative treatment is carried out. Furthermore, in selected patients, splenorrhaphy is a safe and effective treatment.

Abdominal Injuries↗
PubMed1982

Continuous ambulatory peritoneal dialysis in diabetics with end-stage renal disease.

Twenty diabetics with end-stage renal disease who had never previously received dialysis treatment were treated with continuous ambulatory peritoneal dialysis for periods of two to 36 months (average, 14.5). Intraperitoneal administration of insulin achieved good control of blood sugar. Even though creatinine clearance decreased significantly (P = 0.001), control of blood urea nitrogen and serum creatinine was adequate. Hemoglobin and serum albumin levels increased significantly (P = 0.005 and 0.04, respectively). Similarly, there was a significant increase in serum triglycerides and alkaline phosphatase (P = 0.02 and 0.05). Blood pressure became normal without medications in all but one of the patients. Retinopathy, neuropathy, and osteodystrophy remained unchanged. Peritonitis developed once in every 20.6 patient-months--a rate similar to that observed in nondiabetics. The calculated survival rate was 93 per cent at one year; the calculated rate of continuation on ambulatory peritoneal dialysis was 87 per cent. We conclude that continuous ambulatory dialysis with intraperitoneal administration of insulin is a good alternative treatment for diabetics with end-stage renal disease.

Adult↗
PubMed1975

Functional evaluation of the porcine heterograft in the mitral position.

In vivo function of glutaraldehyde-fixed porcine heterografts used for mitral valve replacement was evaluated by cardiac catheterization in 14 of our first 33 patients who have undergone mitral valve replacement with this prosthesis. Diastolic gradients were present in each patient. Average mean diastolic gradient was 6.5 mm Hg for the group, and average end-diastolic gradient was 3.0 mm Hg. Calculated mitral valve orifice areas ranged from 0.92 cm2 to 3.39 cm2, the average being 2.15 cm2. With rapid pacing (heart rate approximately 140), average mean gradient increased by 6 mm Hg. No patient had mitral regurgitation. Two patients had calculated mitral valve areas of 1 cm2 or less; one of these was found at postmortem examination to have thrombus adherent to the ventricular aspect of 2 of the 3 valve leaflets, rendering them immobile.

Adult↗
PubMedDate not supplied

Successful chemotherapeutic decompression of primary endodermal sinus tumor presenting with severe spinal cord compression.

Management of spinal cord compression from a primary paraspinal endodermal sinus tumor (EST) is described. A 17-month-old child presented for treatment with near-complete paraplegia secondary to spinal cord compression from a primary paraspinal EST. The child was treated with cisplatin-based chemotherapy without laminectomy or radiation therapy. Rapid resolution of symptoms was observed. The child had an excellent tumor response and complete neurologic recovery with no sequelae. Chemotherapy alone is an alternative to laminectomy or radiation therapy in the management of epidural cord compression from EST, even when the cord compression is severe.

Endodermal Sinus Tumor↗
PubMedDate not supplied

In vivo determination of optical properties of normal and tumor tissue with white light reflectance and an empirical light transport model during endoscopy.

Determination of tissue optical properties is fundamental for application of light in either therapeutical or diagnostics procedures. In the present work we implemented a spatially resolved steady-state diffuse reflectance method where only two fibers (one source and one detector) spaced 2.5 mm apart are used for the determination of the optical properties. The method relies on the spectral characteristics of the tissue chromophores (water, dry tissue, and blood) and the assumption of a simple wavelength dependent expression for the determination of the reduced scattering coefficient. Because of the probe dimensions the method is suited for endoscopic measurements. The method was validated against more traditional models, such as the diffusion theory combined with adding doubling for in vitro measurements of bovine muscle. Mean and standard deviation of the absorption coefficient and the reduced scattering coefficient at 630 nm for normal mucosa were 0.87+/-0.22 cm(-1) and 7.8+/-2.3 cm(-1), respectively. Cancerous mucosa had values 1.87+/-1.10 cm(-1) and 8.4+/-2.3 cm(-1), respectively. These values are similar to data presented by other authors. Blood perfusion was the main variable accounting for differences in the absorption coefficient between the studied tissues.

Algorithms↗
PubMedDate not supplied

Outcome of the prenatally diagnosed congenital cystic adenomatoid lung malformation: a Canadian experience.

UNLABELLED: Congenital cystic adenomatoid malformation of the lung (CCAM) is diagnosed by prenatal ultrasonography with an increasing frequency but controversy persists as to its prognosis and prenatal management. METHOD: A multi-institutional study of cases of CCAM diagnosed antenatally identified by ultrasonographers and by a review of hospital charts. RESULTS: We obtained 48 cases from five centers. We estimate the incidence of CCAM at 1:25,000 to 1:35,000 pregnancies. The incidence of voluntary abortions was 15% (7/48), of spontaneous abortions 2% (1/41) and of postnatal death 10% (4/40). One of the postnatal deaths was from trisomy 18. Of the 7 aborted fetuses, 2 had multiple malformations and 1 had severe hydrops and oligohydramnios; the other 4 had a large mass with mediastinal displacement but without hydrops. When pregnancy was allowed to continue, 56% of the lesions regressed spontaneously, even though one third of these had initial progression. In 17 cases (42%) the mediastinal shift corrected itself, sometimes by simple growth of the fetus but most often by a decrease in the size of the lung mass. In 1 fetus, repeated needle decompressions followed by double-pigtail catheter drainage of large cysts allowed regression of hydrops. Despite this, neonatal death occurred from pulmonary hypoplasia. CONCLUSION: CCAM can lead to fetal or neonatal demise from hydrops, lung hypoplasia, prematurity or severe associated malformations, but has a good prognosis in the majority of cases.

Abortion, Induced↗
PubMedDate not supplied

A porcine model of gastroesophageal reflux.

The exact mechanism by which the lower esophageal sphincter (LES) prevents gastroesophageal reflux disease (GERD) remains controversial. The two main reasons for this controversy are the lack of a good animal model and the only recent technologic advances in this field. To date, no animal models exist that use 24-hour pH studies, manometry, and endoscopy in evaluating GERD. The purpose of this study is to create a good model of GERD that uses this technology and to delineate the true nature of the LES more clearly. Recently, three-dimensional vector volume studies were performed and through detailed, cadaveric, anatomic studies, the vector volume profiles were correlated to distinct groups of muscle fibers at the gastroesophageal junction in humans. In this study, an anatomic analysis of the porcine gastroesophageal junction revealed an arrangement of muscle fibers similar to that in humans. A myectomy of the porcine oblique fibers was performed in nine piglets weighing 10 to 12 kg. The authors were able to demonstrate manometric attenuation of the porcine LES, gastroesophageal reflux by ambulatory 24-hour pH monitoring (P < 0.0025), and the creation of GERD by documenting esophagitis grossly and histologically. In conclusion, this model of GERD works and lends further support to the notion that the LES may be a discrete anatomic entity.

Animals↗