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Biomedical subjects

J Fisher

Publications and source records attributed to J Fisher.

At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

Sudden death in the dysphagic stroke patient--a case of airway obstruction caused by a food bolus: a brief report.

The clinical events leading up to the sudden death of a dysphagic stroke patient with dementia is described. A 63-yr-old man sustained right thalamic and mid-brain infarctions. On the inpatient stroke rehabilitation ward, he exhibited significant impulsivity and dementia, the latter felt to be premorbid. The patient frequently coughed, and modified barium swallow testing showed dysphagia, with aspiration occurring only when consuming greater than teaspoon amounts of liquid. He subsequently died at home while eating a meal. Autopsy showed an intact large cheese ball (bocconcini) occluding the airway. Sudden death in the impulsive stroke patient secondary to airway occlusion by a food bolus has not previously been reported, although such patients seem to be at greater risk. New eating-related interventions are warranted for dysphagic patients who exhibit impulsivity. It is proposed that food particle size be limited to 1 cm2 and that such patients be closely monitored while eating.

Airway Obstruction↗
PubMedDate not supplied

Relationship of endomysial antibodies to jejunal mucosal pathology: specificity towards both symptomatic and asymptomatic celiacs.

Serum immunoglobulin A class antibodies reactive to the endomysial lining of the smooth muscle bundles of the gastrointestinal tract have recently been reported to be specific and sensitive indicators of celiac disease (CD). A total of 203 subjects were examined for serum endomysial antibodies (EmA) and in 103 small bowel biopsies were obtained. EmA were detected in 43 cases including 26 CD patients evaluated during the gluten challenge phase of diagnosis by European Society for Pediatric Gastroenterology and Nutrition criteria, 11 of 53 symptomatic patients, and 6 asymptomatic family members. All patients with detectable antibody at the time of biopsy exhibited grade III-IV villous atrophy. Disaccharidase activities performed in 19 cases revealed severe deficiencies. EmA were not detected in 160 subjects including 42 infants and children with chronic nonspecific diarrhea. Eighteen of these possessed grade II-III villous atrophy with moderate disaccharidase deficiency and 24 were found to have normal histology and enzymes. The EmA were also not detected in 3 CD patients who were well maintained on a gluten-free diet for greater than 1 year and 25 asymptomatic family members exhibiting normal histology and enzymes. An additional 90 infants and children with other gastrointestinal and liver diseases were also negative for the serum EmA. Fourteen of these patients underwent biopsies and were demonstrated to have normal histology.

Adolescent↗
PubMedDate not supplied

Repair of traumatic cervical esophageal stenosis using microvascular free jejunum transfer.

Three cases of nonneoplastic stricture of the cervical esophagus and pharynx repaired by free jejunal transfer are reported. This technique permits repair of various circumferential defects of the pharynx and esophagus in a single stage without compromising laryngeal function. None of the patients required subsequent dilatation to restore satisfactory swallowing.

Adolescent↗
PubMedDate not supplied

Effect of radiotherapy on the outcome of pharyngeal reconstruction using free jejunal transfer.

Eighteen patients had free jejunal reconstruction of the pharynx and cervical esophagus following pharyngoesophagectomy for malignant tumors. Four patients had no radiation therapy, four had postoperative radiotherapy, and ten had preoperative radiotherapy. Comparison of complication rates indicated no increased risk of complication in patients receiving 6,100 to 6,400 rad of postoperative radiotherapy. Patients having preoperative radiotherapy had a higher incidence of graft failure due to vessel thrombosis, suggesting that radiation endarteritis may increase the risk of graft failure.

Adult↗
PubMedDate not supplied

A simple insulated cot for neonates.

Commercially available transport incubators are sophisticated and expensive since they are designed to provide life support for premature or critically ill neonates. In maternity hospitals with inadequate heating systems, some healthy infants have difficulty maintaining their body temperature in wards and during transfer within the hospital. These babies do not require the sophistication of commercial incubators. We describe a simple insulated cot which meets these requirements at minimal cost.

Beds↗
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A universal air-bubble detector for infusion pumps.

A universal air-bubble detector has been developed for use with drip-controlled infusion pumps. Variations in the peak intensity of modulated infra-red radiation transmitted through the infusion line are used to detect the passage of an air gap or bubble. The device is unique in that bubbles in clear and opaque fluids are detected in most of the standard solution administration sets. The bubble detector is small and light and is an inexpensive way of upgrading an infusion pump to provide an air-in-line alarm facility.

Embolism, Air↗
PubMedDate not supplied

Infant respiration monitoring--evaluation of a simple home monitor.

A new, inexpensive commercial infant respiration monitor, the Baby-Sitter by Direct Diagnostics Ltd, has been evaluated and subjected to clinical trial. Dual respiration recordings were made from infants exhibiting apnoeic episodes to compare the new monitor with an acceptable reference monitor (Graesby Medical Model MR10). Both monitors are designed to detect respiration movement by means of pressure pulses produced in an air-filled sensor attached to the infant's abdomen. The new monitor is found to have unacceptable performance.

Apnea↗
PubMedDate not supplied

A microcomputer-based data acquisition system for a prosthetic heart valve test apparatus.

The hydrodynamic testing of prosthetic heart valves in the laboratory under pulsatile flow conditions remains the only way of obtaining detailed information about valve function. Test procedures have become increasingly sophisticated, with a variety of different test conditions and detailed analysis of the pressure and flow signals. A computerized data acquisition system has been developed for use with the Glasgow pulsatile flow test apparatus. The computer collects seven signals from the test rig over a period of 20 s, and calculates the average waveform for each signal. Standard parameters, such as mean pressure differences, mean flows, regurgitant volumes and energy losses, are calculated automatically. The complexity of the analysis and the need for standardized documentation makes computerization essential. The system has been used extensively for function tests on over 160 prosthetic heart valves.

Biomedical Engineering↗
PubMedDate not supplied

Ceramic bearing surfaces in total artificial joints: resistance to third body wear damage from bone cement particles.

Studies of explanted Charnley hip prostheses have shown damage or scratching of the polished stainless steel femoral heads. This surface damage is probably due to third body wear by bone cement particles. Damaged femoral heads will produce increased wear rates of ultra high molecular weight polyethylene (UHMWPE) acetabular cups. Sliding wear tests carried out in the laboratory have shown that alumina ceramic counterfaces are more resistant to third body damage from bone cement particles than stainless steel counterfaces. The use of the ceramic femoral heads in artificial hip joints will help to preserve the smooth surface finish on the femoral bearing surface, which is necessary to ensure low wear rates of the UHMWPE cup throughout the lifetime of the prosthesis.

Biocompatible Materials↗
PubMedDate not supplied

Median nerve function in patients undergoing carpal tunnel release: pre- and post-op nerve conductions.

Patients undergoing surgery for carpal tunnel decompression may improve clinically, however it is not well known as to how median nerve neurophysiology is altered following surgery. Fifty patients who underwent open carpal tunnel release were prospectively studied. Each patient underwent nerve conduction studies pre-op and at 6 months post-op. Patients were also asked to answer several questions regarding their clinical symptoms to see how they improved. 48/50 patients had clinical improvement based on their response (resolution of nocturnal paresthesias, decreased sensory complaints and pain). Average pre- and post-op parameters were as follows: distal motor latency (DML) (msec) 5.24/4.42; distal motor amplitude (mV) 8.28/8.64; sensory conduction velocity (m/sec) 38.9/41.0; sensory amplitude (uV) 10.94/15.61. We conclude that the DML and sensory amplitude showed significant improvement following surgery; the sensory conduction velocity remains slow.

Carpal Tunnel Syndrome↗