Search PubMed⌕ Search

Biomedical subjects

G W Nixon

Publications and source records attributed to G W Nixon.

At least 19 recordsLinked to original sources

Fluoroscopic foley catheter removal of esophageal foreign bodies in children: experience with 415 episodes.

OBJECTIVE: This study sought to investigate the safety and efficacy of the fluoroscopic Foley catheter technique (FFCT) for removal of esophageal foreign bodies (EEBs) in children, and to identify factors associated with decreased success. DESIGN/SETTING/PATIENTS: An 11-year retrospective review of all pediatric patients undergoing the FFCT for removal of EFBs at a tertiary-care children's hospital was performed. RESULTS: Four-hundred and fifteen cases are reported. The median age was 29 months (range, 4 to 193); children < or = 24 months accounted for 45% (185) of the cases. Of all episodes 86% (355) involved children without known esophageal pathology. Coins comprised 76% (316) of the EFBs. The FFCT was successful in 91% (378) of the cases. In the 60 episodes involving children with underlying esophageal pathology, the technique had an 83% success rate compared to 92% in children without known pathology (P < .05). There were 290 patients where the duration of impaction was known. The success rate was 96% if the duration was 3 days or less compared to 50% if the duration was longer (P < .0001). Though the overall success in children < or = 24 months was less than older children (88% vs 94%, P < .05), this effect disappeared when corrected for duration of impaction. Minor complications occurred in 2% of the episodes, and major complications were noted in 1%. CONCLUSIONS: The FFCT appears to be a safe and effective method for removal of EFBs especially in children without underlying esophageal lesions and a duration of impaction < or = 3 days. Major complications are rare.

Catheterization↗

Quality of object relations versus interpersonal functioning as predictors of therapeutic alliance and psychotherapy outcome.

The purpose of the study was to compare an interview measure of quality of object relations to questionnaire and interview measures of recent interpersonal functioning with respect to the prediction of therapeutic alliance and psychotherapy outcome. The sample consisted of 64 patients who had received approximately 20 sessions of short-term individual psychotherapy within a controlled, clinical-trial investigation. Ratings of therapeutic alliance were provided independently by the patient and the therapist after each session. Outcome measures, which were provided by three sources (patient, therapist, and independent assessor), covered the areas of interpersonal functioning, psychiatric symptomatology, self-esteem, and life satisfaction. Quality of object relations, which characterizes the patient's lifelong pattern of relationships, was the best predictor. It was significantly related to patient-rated and therapist-rated therapeutic alliance and to patient improvement of both general symptomatology and specific target problems. The study also replicated previous studies that have reported significant relationships between therapeutic alliance and therapy outcome. The advantages of pretherapy predictors of therapy outcome, such as quality of object relations, are discussed.

Adjustment Disorders↗

The Quality of Object Relations Scale.

The Quality of Object Relations Scale (QORS) provides a methodological and theoretical framework for personality classification based on relative level and quality of object relations. The authors believe that many available clinical assessment systems have little heuristic value, and propose that the QORS yields more meaningful descriptions of people. They discuss its theoretical basis in psychoanalytic object relations theory, and how its construction and rationale represent an attempt to incorporate recent thought relevant to the classification of personality. They include criteria for its organizational levels, prototypical vignettes, and a case demonstration. They also explore methodological issues relevant to clinical use and present reliability and validity data derived from empirical studies.

Adult↗

Epiphyseal growth plate: evaluation with modified coronal CT.

A method of modified coronal computed tomography (CT) was developed for examination of epiphyseal growth plate arrest and neoplasms near the growth plate. Twenty-four patients were examined with this technique (26 examinations). In all cases, the growth plate and adjacent regions were well demonstrated.

Adolescent↗

Trampoline fracture of the proximal tibia in children.

Seven children (aged 2-5 years) sustained fractures of the proximal tibial metaphysis while jumping on a trampoline with a heavier child or adult. Most impaction fractures were transverse and neither angulated nor displaced. None of the children developed permanent disability or impairment. Parents and physicians should be aware of the possible danger to small children while tandem jumping on a trampoline with a heavier partner.

Athletic Injuries↗

Infants of diabetic mothers: radiographic manifestations.

The radiographic findings of a series of infants of diabetic mothers and a review of the literature are presented to illustrate the wide spectrum of abnormalities that may be seen with this condition. Congenital anomalies of the spine and skeletal, genitourinary, and cardiovascular systems and visceral situs inversus are significantly more frequent among infants of diabetic mothers than normal. The most specific anomaly is sacral agenesis. Renal vein thrombosis and adrenal hemorrhage are also more common and may be diagnosed by sonography. Over one-half of the cases of the small left colon are associated with maternal diabetes and may be diagnosed and treated with a contrast enema. The incidence of the respiratory distress syndrome is higher in infants of diabetic mothers than other premature infants, and the disease may occur in the presence of reliable indicators of lung maturity. Other common causes of dyspnea include cardiomyopathy, congenital heart disease, wet lung syndrome, hyperviscosity syndrome, and persistence of fetal circulation. Echocardiography is the most valuable adjunct in differentiating cardiac from pulmonary problems.

Birth Weight↗

Congenital macular colobomas and short-limb skeletal dysplasia.

We report a previously undescribed association of severe short-limbed dwarfism and macular colobomas with histological changes of cartilage resembling to some extent those of diastrophic dysplasia. Chance occurrence of two rare disorders due to different causes is considered unlikely and the patient is presumed to have a syndrome of, as yet, unknown cause.

Bone and Bones↗

The lack of correlation between upper tract changes on excretory urography and significant vesicoureteral reflux.

In a retrospective review of all excretory urograms and voiding cystourethrograms performed in a 1-year period in 391 children evaluated with a history of urinary infection 56 (14 per cent) had vesicoureteral reflux as well as a normal excretory urogram. Of the 89 children in the study with vesicoureteral reflux 56 (63 per cent) had a normal excretory urogram. The grade of reflux was II or greater in 49 per cent of the cases, which also had a normal excretory urogram. We conclude that an excretory urogram without a voiding cystourethrogram is an inadequate study for a child with a history of urinary infection.

Child, Preschool↗

Adult GM1 gangliosidosis: clinical and biochemical studies on two patients and comparison to other patients called variant or adult GM1 gangliosidosis.

Two young adult siblings were diagnosed as having a deficiency of acid beta-galactosidase activity in leukocytes and fibroblasts. The parents had enzyme levels approximately half of the normal level, consistent with this being the primary enzymatic lesion. Sialidose activities measured with natural and synthetic substrates in the patient's skin fibroblast cultures were normal. Hybridization of one of these patient's cells with cells from a patient with GM1 gangliosidosis, Type 1 did not show complementation of beta-galactosidase activity. However, when the cells from the patient were hybridized with cells from a patient with combined sialidase and beta-galactosidase deficiency, complementation was observed. These two siblings have ataxia, mild intellectual deterioration, slurred speech, mild vertebral changes and little, if any, visceromegaly. They do not have myoclonus, seizures or cherry-red spots, which are found in most patients with combined sialidase and beta-galactosidase deficiency. These patients are discussed with regard to other patients in the literature called variant or adult GM1 gangliosidosis.

Adult↗

Foley catheter method of esophageal foreign body removal: extension of applications.

The fluoroscopically controlled Foley catheter technique can be used to remove nonopaque esophageal foreign bodies that are smooth or soft and foreign bodies in patients with esophageal strictures or after esophageal atresia repair. These situations have previously been felt to be contraindications for this procedure. Successful treatment was accomplished in 21 of 25 patients.

Adolescent↗

Unusual features of pulmonary sling.

Patients with an anomalously placed left pulmonary artery ("pulmonary sling") typically have signs and symptoms of respiratory obstruction in the neonatal period. Experience with four previously unreported patients confirmed this. Typical radiographic features include unilateral air trapping (usually on the right side), an abnormal position of the esophagus, and a soft tissue mass interposed between the trachea and esophagus. Less common findings include a normal esophageal position, left-side air trapping, and delayed egress of neonatal pulmonary fluid. Both typical and atypical features were seen; the more unusual aspects are emphasized.

Apnea↗

Right atrial ball-valve thrombus: a complication of central venous alimentation in an infant. Diagnosis and successful surgical management of a case.

The following is a case report of a 6-week-old premature infant in whom a ball-valve thrombus developed after prolonged central venous alimentation. Clinical presentation included facial edema, cyanotic episodes, and apnea. No murmur was present, but the diagnosis was suspected when a calcified right atrial mass became apparent on the plain chest film. The diagnosis was confirmed by echocardiography and then venous and cardiac angiography. The calcified thrombus was removed successfully from the right atrium by use of profound hypothermia with ether anesthesia and total circulatory arrest. Subsequently, the patient made an uneventful recovery and is healthy 3 years postoperatively.

Calcinosis↗

Radiographic findings in children surveyed for enuresis.

Over a one-year period 216 children had a radiographic survey of their urinary tracts performed for the evaluation of enuresis with many of these having a precedent history of urinary infection as well. Significant urinary tract abnormalities were found in 27 per cent of the children. Clinical correlation was obtained in 135 of these children with 19.3 per cent requiring surgery. The groups of children with a history of diurnal enuresis or urinary infection were quite different from the group with nocturnal enuresis alone. These differences are discussed.

Age Factors↗

Retroperitoneal lipoma in a child.

A case of retroperitoneal lipoma in a child is presented. A lucent retroperitoneal mass was seen displacing the kidney and ureter without intrinsic renal involvement.

Child, Preschool↗

Hematogenous osteomyelitis of metaphyseal-equivalent locations.

Flat and irregular bones have anatomic subdivisions comparable to long bones. This concept is useful in the radiograpic evaluation of solitary bone lesions. Areas adjacent to cartilage are metaphyseal-equivalent locations. Prior to skeletal maturation, metaphyseal-type vascular anatomy predisposes these sites to involvement by hematogenous osteomyelitis. Approximately 30% of cases of hematogenous osteomyelitis affect these metaphyseal-equivalent sites and often present difficult diagnostic challenges. Forty-nine patients with this condition are described.

Adolescent↗