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Biomedical subjects

G Moss

Publications and source records attributed to G Moss.

At least 19 recordsLinked to original sources
PubMed1997

Congenital renal tubular dysplasia and skull ossification defects similar to teratogenic effects of angiotensin converting enzyme (ACE) inhibitors.

An apparently autosomal recessive syndrome of congenital renal tubular dysplasia and skull ossification defects is described in five infants from two separate, consanguineous, Pakistani Muslim kindreds. The clinical, pathological, and radiological features are similar to the phenotype associated with fetal exposure to angiotensin converting enzyme (ACE) inhibitors: intrauterine growth retardation, skull ossification defects, and fetal/ neonatal anuric renal failure associated with renal tubular dysplasia. There was no fetal exposure to ACE inhibitors in the affected infants. Phenotypic similarities between these familial cases and those associated with ACE inhibition suggest an abnormality of the "renin-angiotensin-aldosterone" system (RAS). It is postulated that the molecular pathology in this uncommon autosomal recessive proximal renal tubular dysgenesis could be related to mutations of the gene systems governing the RAS.

Abnormalities, Drug-Induced↗
PubMed1996

Raising the outcome standards for conventional open cholecystectomy.

BACKGROUND: Postcholecystectomy length of stay declined after the introduction of laparoscopy in 1987. Technology deserves some credit for reducing iatrogenic trauma. However, the improved outcome primarily resulted from setting higher surgical standards. What goals were (and are) achievable with the conventional "open" technique? METHODS: One surgeon performed 160 consecutive open cholecystectomies from 1983 to 1987. The patients averaged 46 years of age (range 13 to 100), 62% were female, and 20% presented acutely. Five (3.1%) had common bile duct exploration. Each patient was prepared to accept early discharge. Prompt ambulation followed minimal tissue handling and use of long-acting local anesthesia. Enteral feeding at 300 kcal plus 12 g AAs/ hour began immediately, with swallowed air and potential excess removed automatically by efficient more proximal aspiration. RESULTS: 160 patients were discharged the next day, 158 of 160 (99%) without receiving any narcotics. They absorbed (on average) 3,350 kcal plus 130 g AAs the initial 8 to 16 hours. Serum branched-chain amino acids (BCAA) levels rose above basal within 4 hours. Three patients (1.9%) were readmitted. One (0.6%) had a sterile biloma drained percutaneously. A single acute cholecystitis patient developed sepsis (0.6%), a subphrenic abscess that resolved after drainage. The sole mortality (0.6%) was caused suddenly 27 days postoperatively by a pulmonary embolus. CONCLUSIONS: Laparoscopy is a valuable surgical tool whose actual incremental benefits are yet to be determined. Shorter length of stay after cholecystectomy may primarily reflect the altered expectations and overall improved surgical performance associated with this innovation.

Adolescent↗
PubMed1994

Time to abandon Brussels' bid on patents.

After six years of debate, the European Commission's attempts to harmonize biotechnology legislation still face opposition over the patenting of genes. Recent legal experience suggests that its efforts are unnecessary.

Animals↗
PubMed1994

Postoperative enteral hyperalimentation results in earlier elevation of serum branched-chain amino acid levels.

To objectively document the immediate maintenance and successful exploitation of postoperative gastrointestinal (GI) function, elemental diet was infused into the more distal duodenum of 30 cholecystectomy patients at 300 kcal per hour, beginning on arrival at the recovery room. Approximately 4,600 kcal and 190 grams of amino acids were absorbed during the initial 16 hours. Serum branched-chain amino acids (BCAAs) had risen above basal levels at 4 hours, statistically significant only for leucine (+64%). The higher concentrations had reached statistical significance for all BCAAs by 6 hours, when leucine had risen by 83%, isoleucine by 54%, and valine by 47%. The elevated BCAA and glucose levels sustained throughout the hyperalimentation period objectively verify that postoperative GI function can be safely exploited, and may contribute to improved wound healing and sepsis resistance.

Amino Acids, Branched-Chain↗
PubMed1992

Human immunodeficiency virus type 1 infection in women attending a sexually transmitted diseases clinic in Kenya.

A cross-sectional study was conducted among women attending a sexually transmitted diseases clinic in Nairobi, kenya, to determine the prevalence of and associated risk factors for human immunodeficiency virus (HIV) type 1 infection. HIV-1 antibody was detected in 13.8% of 600 women. This virus was found most frequently in prostitutes (odds ratio [OR], 7.2), in women reporting a history of genital ulcers (OR, 2.3), and in those with a current diagnosis of genital ulcers (OR, 5.1). Lifetime duration of oral contraceptive use was significantly greater in HIV-1-positive women. Multivariate analysis revealed an association between genital ulcers and HIV-1 infection (OR, 3.8). The strongest association for HIV-1 infection, however, occurred with genital ulcers in combination with the use of oral contraceptives (OR, 25.7).

Adult↗
PubMed1992

Nasogastric tube "suction-buster holes" release mucosal occlusion despite high suction.

Aspiration devices can persistently malfunction if moderate (not just high) suction causes mucosal occlusion of every opening. The standard pattern of uniformly large orifices was modified by supplementing half the nasal tubes with smaller (one tenth of the area) openings. Ten pairs of postoperative patients sipped water while suction applied to their nasal tubes varied from 40 to 300 mm Hg. Unmodified tubes consistently functioned only when applied vacuum was below 60 mm Hg. At 60 mm Hg, 20% (2/10) of tubes malfunctioned, with swallows failing to return on three consecutive attempts even at this gentle level. The failure rate rose with increasing applied suction. All 10 devices evidenced persistent occlusion when the vacuum exceeded 90 mm Hg. Each adverse result was confirmed by continued malfunction when suction was increased by another 10 mm Hg. The brisk flow through large esophageal openings dramatically differs from restricted inflow. Supplementing the standard set of uniform, large-bore aspiration orifices with additional small openings results in unimpeded function over the full range of available hospital vacuum. The additional small openings permitted the turbulent evacuation characteristic of large-bore patency. No device with accessory "suction-buster" orifices malfunctioned at even the highest available suction (300 mm Hg).

Cholecystectomy↗