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Biomedical subjects

H Slater

Publications and source records attributed to H Slater.

At least 55 records · Page 3Linked to original sources
PubMed1981

Burns in older patients.

An increasing percentage of the burn victims admitted to the Western Pennsylvania Hospital and Burn Care Center are aged 65 or older. Among 108 such elderly patients admitted during the past six years, 68 died and 40 survived--a mortality rate of 63 percent. Those who died of burns (average age 76.4) had burns over 44.8 percent of the mean body surface, whereas the survivors (average age 73.5) had burns over a smaller area (16.7 percent). Survival also was related to the presence of significant heart and lung disease which antedated the thermal injury. Treatment of the burns was in keeping with standard recommendations for intravenous fluid resuscitation, wound care, and skin grafting. Cimetadine and antacids proved effective in the prevention of significant gastrointestinal bleeding. Ninety percent of the survivors returned to their homes after treatment. Although the mortality for elderly burn patients remains high, the favorable results in rehabilitation of the survivors are encouraging. Increased attention should be paid to safety programs for the elderly and those who care for them to prevent such serious accidental injuries.

Aged↗
PubMed1981

[Giant duodenal diverticula with heterotopic gastric mucosa. Its demonstration with technetium 99].

The duodenal diverticulum, except for occasional findings, are diagnosed by their complications, these are found in 10% of the cases and they are: 1) diverticulitis 2) haemorrhage 3) mechanic disturbances 4) perforation 5) obstruction 6) malabsorption syndrome. The case that motivated our communication appeared as a massive haemorrhage, that was medically treated considering the high mortality, rate of the surgical procedures. As the duodenal diverticuli can be cause of acute or chronic digestive haemorrhage, and this is frequently due to the erosion produced, by the heterotopic gastric mucosae, we consider that its demonstration with technetium 99 can be a valuable diagnostic method, as has already been demonstrated in other pathologies that present heterotopic mucosae, and as has been demonstrated in our case.

Diverticulitis↗
PubMed1975

Direct inoculation procedure for the rapid classification of bacteria from blood culture.

A procedure was developed for 4-h identification of bacteria from blood culture. From a turbid blood culture bottle a 10- to 15-ml aliquot was drawn off and centrifuged. The pellet was utilized to inoculate a series of enzymatic and physiologic reactions. Three hundred eight positive blood cultures were tested including 222 strains of Enterobacteriaceae, 40 strains of facultative grampositive cocci, 26 strains of anaerobes, and 20 assorted strains. There was over 96.5% agreement between 4-h and conventional methods with the Enterobacteriaceae, 98% with facultative gram-positive cocci, 100% with anaerobes, and 99% with the assorted strains.

Bacteria↗
PubMedDate not supplied

Inhalation injury with burns: a lethal combination.

Inhalation injury is known to add significant morbidity and mortality to patients with burns. Estimating the severity of inhalation injury is difficult, as signs of respiratory failure may occur hours or even days after the injury. We have reviewed 86 consecutive patients who were admitted to our Burn/Trauma Center with burns and evidence suggestive of smoke inhalation. Of these patients, 88% required endotracheal intubation. There was a 62% mortality. Admission chest x-rays studies, PAO2, and auscultation of the patient's lungs were normal in 90% of the study group. These factors could not be used to predict respiratory failure or death. Patients with as little as 15% total body surface burns with mild smoke inhalation are at significant risk of respiratory failure and the need for ventilatory support.

Adolescent↗
PubMedDate not supplied

Multidisciplinary approach to working with burn victims of child abuse.

Successful outcomes in abuse cases are dependent upon close coordination of professional hospital staff with referring agencies including child protective services and the legal and judicial systems. A four-year retrospective study of 369 pediatric burn patients admitted to our Burn/Trauma Center was completed to: (1) assess demographic factors of patients and families that differentiate cases of child abuse from cases of children burned as a result of accidental injury, and (2) determine the impact of a multidisciplinary team approach to working with abused children and their families during the course of hospitalization. When medical evaluation reveals the possibility of child abuse, a social work assessment, including a developmental history of the child and psychosocial assessment of the family, is crucial. In addition, physicians must be well versed in the gathering of evidence for potential utilization by the legal system. This includes the obtainment of photographs and detailed documentation of the burn injury. A plan of evaluation and the effective coordination of services during hospitalization and following discharge have proven essential to meeting the best interests of the child.

Burns↗
PubMedDate not supplied

Acute septic cholecystitis in patients with burn injuries.

Acute cholecystitis continues to be a life-threatening complication in patients after trauma. In an 18-month period we have recognized and treated five patients with burn injuries who had acute cholecystitis. They ranged in age from 13 to 40 years. Four of the five patients had positive blood cultures and all five patients had positive bile cultures. The diagnosis was made on the basis of unexplained sepsis and an abnormal sonogram or hepatobiliary scan. Four patients underwent cholecystectomy and one patient underwent a cholecystostomy. Four patients survived and were discharged from the hospital. All five patients were receiving nutritional support. Factors such as prolonged fasting, dehydration, narcotic administration, and sepsis have been suggested as contributing factors in the development of acute cholecystitis. Acute cholecystitis is a serious complication in such patients and must be considered and treated promptly. Serial ultrasound studies have been helpful in managing patients suspected of having acute septic cholecystitis.

Adolescent↗
PubMedDate not supplied

Effect of aggressive surgical treatment in older patients with burns.

A group of 103 patients with burns, 65 years old and older, was compared with a similar group treated a decade ago. The survival rate of the early group was 37%, and the survival rate of the currently treated group is 52%. The length of stay in the hospital of surviving patients dropped from 42 to 22 days. Ten years ago 62% of surviving patients with burns in our series were operated on. In the more recently treated group with improved survival and decreased lengths of stay, 90% of the patients had one or more operations. We believe that early excision of eschar and early wound closure are associated with increased survival and decreased length of stay for older patients with burns.

Aged↗