Search PubMed⌕ Search

Biomedical subjects

J H Kerr

Publications and source records attributed to J H Kerr.

At least 37 records · Page 2Linked to original sources
PubMed1985

Automatic blood pressure monitors. A clinical evaluation of five models in adults.

Five automatic blood pressure monitors were evaluated by comparing their values with almost simultaneous blood pressure readings from radial artery catheters. A total of 583 comparisons were made on 48 patients. Statistical analysis was performed on the pooled comparisons of systolic and diastolic pressure for each monitor. Agreement between the pressure measurements was variable between both patients and machines. For systolic pressure, two machines (Copal and Sentron) had correlation coefficients of over 0.9 while for the other machines (Dinamap 845XT, Narco and Vitastat 9001S) the values lay between 0.7 and 0.8. The steepest regression lines were also found with the Copal (0.93) and Sentron (0.86) data, but the other machines had considerably flatter slopes (0.55 to 0.67). The intercepts on the Y axes ranged from +14.1 (Copa) to +50.1 (Dinamap). In clinical use, popularity of the different machines reflected the degree to which the machine reproduced the behaviour of the direct pressure measurement.

Adult↗
PubMed1984

Unilateral high frequency jet ventilation. Reduction of leak in bronchopleural fistula.

A young alcoholic presented with severe bilateral bronchopneumonia, which required prolonged treatment with intermittent positive pressure ventilation. High airway pressures were necessary for effective gas exchange. A recurrent tension pneumothorax led to a persistent bronchopleural fistula which resulted in hypercarbia and hypoxaemia despite the use of large minute volumes. Surgical resection was not considered feasible because of extensive local infection. Asynchronous independent lung ventilation was instituted, using a double-lumen endobronchial tube. A considerable leak still occurred through the bronchopleural fistula, and it was only when high frequency jet ventilation was substituted to the fistula-containing lung that the leak was virtually abolished, while improving gas exchange. High frequency jet ventilation in bronchopleural fistula is of potential benefit.

Adult↗
PubMed1983

Paratracheal abscess after tracheostomy.

Mediastinal abscess formation in the paratracheal region is a complication of tracheostomy that has previously been only sparsely reported. We present a case which highlights this complication and illustrates some of the diagnostic difficulties with which it may be associated. In this case septicaemia-developed as a secondary complication and diagnosis of the abscess was dangerously delayed because the radiographic appearance masqueraded as a left upper lobe consolidation and because its rarity led to a low index of suspicion.

Abscess↗
PubMed1983

Retinal reflex photometry as a screening device for amblyopia and preamblyopic states in children.

Aberration in the physical structure or alignment of the eyes may produce pathologic neurocompensatory changes in the brain that, if left unattended, become irreversible. Two common examples of this abnormal state are accommodative esotropia and amblyopia. Both have a large optic component in their etiology and in most cases are correctable by optic methods. Generated retinal reflex photometry is a screening method that can detect, in the eyes of children, optic defects that tend to be the antecedents of more serious neurocompensatory processes. Detection at an early age permits more effective management and treatment of amblyopia. This technique is fast, safe, and inexpensive and provides a permanent record. It requires no response from the subject except a modicum of cooperation. It is attractive as an ocular screening method because it does not require highly trained personnel to administer the examination, yet appears to be accurate. The results lend themselves to mechanized processing.

Age Factors↗
PubMed1981

Insensible fluid losses in severe tetanus.

Insensible fluid losses were estimated using fluid balances and body weight changes in twelve artificially ventilated patients with severe tetanus. Studies were carried out over initial twenty day periods of treatment on six patients aged between 26 and 49 years and six aged 63 to 78. Nine of the 12 patients lost weight over the study period (the younger losing an average of nearly 10% of their body weight) and all patients had positive fluid balances ranging between 15 and 53 1. The discrepancy between these findings was explained on the basis of considerable and continuing fluid losses in the form of sweat and saliva. When quantified, insensible fluid losses appeared greatest in the younger patients (up to 3.81 per day) and increased throughout the period of study. Dehydration will tend to occur unless the magnitude of these insensible losses is appreciated and taken into account when managing fluids.

Adult↗
PubMed1981

Bupivacaine infiltration after lumbar laminectomy. Local infiltration in the control of early postoperative lumbar laminectomy pain.

This is a report of a double-bind controlled trial to test the hypothesis that peroperative local infiltration of the wound of lumbar laminectomy with bupivacaine produces a significant reduction in postoperative back pain. No such effect was demonstrated when the linear analogue was used to record the patients' subjective response to pain. It is suggested that this treatment is not indicated as a routine method.

Adult↗
PubMed1981

Extradural diamorphine in the control of pain following lumbar laminectomy.

Catheters were inserted into the extradural space under direct vision at the time of surgery for prolapsed intervertebral disc or lumbar canal stenosis. In the post-operative period, diamorphine (3 mg in 5 ml water) was injected through the catheter when patients requested analgesia. In only four of 49 patients was significant pain relief not achieved after extradural diamorphine injection. In four other patients it was not possible to use this method of analgesia throughout the two post-operative days as planned. As judged by the improved mobility and by grading on a linear analogue pain scale, the quality of analgesia achieved was better than after intramuscular papaveretum (10-20 mg) and extradural diamorphine was requested less frequently. There were no serious side-effects in the patients studied, although the technique was not used in patients over 55 years of age. Extradural diamorphine appeared to be less effective in two patients who had undergone re-explorations.

Adolescent↗
PubMed1978

Pheochromocytoma in the modern context.

The hypertensive patient faces an uncertain future. Therefore a search for those cases in which the condition is potentially curable is eminently worth while and has become increasingly productive because of the specific diagnostic aids now available and because of the present safety of surgical intervention. Detection and localization of a pheochromocytoma allows a planned surgical approach. Correction of hypovolemia preoperatively ensures a safe course postoperatively. The use of blocking agents pre- and peroperatively prevents the hazardous hypertensive crises and arrhythmias that were a part of early surgical experience. Monitoring of central venous and arterial pressures as well as the electrocardiographic tracing during the operation permits prophylactic therapy when necessary. On the basis of a series of 31 patients the authors compare many aspects of the current management with earlier experience of pheochromocytoma in the same institution. The incidence of extra-adrenal lesions (3.8%), multicentric tumours (3.8%) and malignant change (11.5%) was lower in this group of patients than that usually reported. Abdominal exploration remains the approach of choice in most cases. Treatment of the solitary pheochromocytoma has become straightforward. However, management of the familial syndromes and the malignant from of the disease still requires careful scrutiny.

Adrenal Gland Neoplasms↗
PubMed1977

Thermographic assessment of peripheral arterial occlusion.

Infra-red thermography was used to confirm the observation that the temperature differences between corresponding areas of skin on opposing hands are normally minimal and to demonstrate that the skin temperature of the hand distal to an occluded radial or brachial artery was lower than that of the contra-lateral hand. Temperature differences between the two hands decreased with time and had disappeared by the time that recannulation of the occluded artery, gauged by the modified "Allen" test, had occurred. Thermography is a simple and noninvasive technique and provides a useful indicator of the incidence and progress of peripheral arterial occlusion such as that which may follow arterial cannulation.

Arterial Occlusive Diseases↗
PubMed1976

Carinal resection. A report of two cases and a description of the anesthetic technique.

Two cases of carinal tumor managed by resection and primary anastomosis are presented. Their course is discussed and a description of an anesthetic technique which obviates the need for cardiopulmonary bypass is presented. The principles of carinal surgery are discussed, emphasizing expert anesthesia and resection line control by frozen-tissue examination.

Anesthesia, Endotracheal↗
PubMed1975

Arterial occlusion after cannulation.

The occurrence of ischaemic changes, arterial occlusion, and other complications which may follow percutaneous arterial cannulation was assessed in a survey of 155 patients. No patient complained of or had signs of ischaemic damage though signs of arterial occlusion were found in 33 patients (22%). These signs were significantly more common after periods of cannulation greater than six hours (43%) than after less than six hours cannulation (17%). During recovery from occlusion all patients had palpable pulsation over the artery even though blood flow seemed to be absent. By the end of follow-up blood flow had returned in 19 of the 33 occluded arteries.

Arterial Occlusive Diseases↗
PubMed1975

Pulmonary oxygen transfer during IPPV in man.

The efficiency of pulmonary oxygen transfer, measured as the difference between pulmonary end-capillary and arterial oxygen content, was assessed at several different inspired oxygen concentrations in 20 patients during intermittent positive pressure ventilation (IPPV) with oxygen/nitrogen mixtures. In only three of the patients did the patterns of response correspond with those predicted from iso-shunt and ventilation/perfusion mismatch models of lung function, in which it is assumed that oxygen exerts only a passive physical effect within the lungs. It is suggested that the pattern of response obtained during IPPV in the remaining 17 patients is explicable on the basis of an active physiological effect of oxygen such that an increasing alveolar oxygen partial pressure is associated with a progressive increase in the proportion of the pulmonary blood flow which bypasses ventilated alveoli. This "hyperoxic shunt", which is readily reversible, may be the result of redistribution of either ventilation or blood flow within the lung.

Adolescent↗